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NPI Code Detail

MEDICARE: HENDRIX PHARMA CORP

MEDICARE: HENDRIX PHARMA CORP
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
13336L0003XLong Term Care Pharmacy

General Provider Information

NPI Number : 1962370957
Entity Type Code : Organization
Provider Name (Legal Business Name) : HENDRIX PHARMA CORP
Provider Business Mailing Address
First Line : 121 LAFAYETTE AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10301-1249
Country : US
Telephone Number : 718-524-7099
Fax Number : 718-524-5700
Provider Business Practice Location Address
First Line : 121 LAFAYETTE AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10301-1249
Country : US
Telephone Number : 718-524-7099
Fax Number : 718-524-5700
Authorized Official
Title or Position : PIC
Name : DR. ALI TAREKTAHA ERFAN
Credential : RPH
Telephone Number : 718-524-7099
Provider Enumeration Date : 10/29/2025
Last Update Date : 10/29/2025

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Directions to “HENDRIX PHARMA CORP ” Practice Location

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