MEDICARE: BARAKA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0004X	Compounding Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336M0003X	Managed Care Organization Pharmacy
4	333600000X	Pharmacy
5	3336C0003X	Community/Retail Pharmacy	030997	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2133570	OTHER		PK

General Provider Information

NPI Number	:	1578834321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARAKA INC

Provider Business Mailing Address
First Line	:	2088 WHITE PLAINS RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-1412
Country	:	US
Telephone Number	:	347-691-3333
Fax Number	:	347-691-3332

Provider Business Practice Location Address
First Line	:	2088 WHITE PLAINS RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-1412
Country	:	US
Telephone Number	:	347-691-3333
Fax Number	:	347-691-3332

Authorized Official
Title or Position	:	OWNER
Name	:	MOHAMED ELADMA
Credential	:
Telephone Number	:	347-691-3333

Provider Enumeration Date	:	01/24/2012
Last Update Date	:	12/12/2014

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Directions to “BARAKA INC ” Practice Location

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