Provider Demographics
NPI:1366506867
Name:7TH AVENUE CHEMIST INC
Entity type:Organization
Organization Name:7TH AVENUE CHEMIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOK DOON JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:AU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-965-9688
Mailing Address - Street 1:679 60TH ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4108
Mailing Address - Country:US
Mailing Address - Phone:718-439-0998
Mailing Address - Fax:
Practice Address - Street 1:679 60TH ST UNIT B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4108
Practice Address - Country:US
Practice Address - Phone:718-439-0998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0281343336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02877530Medicaid
3352767OtherOTHER ID NUMBER