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General NPI Number Information
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NPI Number | 1518344274
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Entity Type | Organization
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Legal Business Name | MYDESH INC
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Dates
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Enumeration Date | 05/01/2015
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Last Update Date | 12/07/2016
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Provider Practice Location Address
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Address Line | 581 NYS ROUTE 17M
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City | MONROE
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State | NY
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Zip | 10950
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Country | US
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Telephone | 845-395-0909
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Fax |
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Provider Business Mailing Address
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Address Line | 60 LINCOLN ST
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City | SLOATSBURG
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State | NY
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Zip | 10974-1217
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Country | US
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Telephone | 845-661-1210
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MOHAMMED IQBAL
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Credential |
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Telephone | 845-661-1210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 033550
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License Number State | NY
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