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General NPI Number Information
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NPI Number | 1881137875
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Entity Type | Organization
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Legal Business Name | EASTERN PHARMACY INC
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Dates
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Enumeration Date | 11/23/2016
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 15913 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432-3935
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Country | US
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Telephone | 917-396-4944
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Fax | 917-396-4926
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Provider Business Mailing Address
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Address Line | 15913 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432-3935
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Country | US
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Telephone | 917-396-4944
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Fax | 917-396-4926
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAHBUB ZAMAN KHUNDKAR
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Credential |
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Telephone | 786-252-3357
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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 | 035006
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License Number State | NY
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