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General NPI Number Information
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NPI Number | 1982766762
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Entity Type | Organization
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Legal Business Name | SUTPHIN DRUGS, INC.
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 14303 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11435-3230
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Country | US
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Telephone | 718-526-0310
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Fax |
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Provider Business Mailing Address
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Address Line | 14303 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11435-3230
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Country | US
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Telephone | 718-526-0310
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AJAI PRAKASH
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Credential | R.PH.
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Telephone | 718-526-0310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy 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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 017989
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License Number State | NY
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