Provider Demographics
NPI:1487069936
Name:PHARMACENA LLC
Entity type:Organization
Organization Name:PHARMACENA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHEHNAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:PALWALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-209-4970
Mailing Address - Street 1:136 NORTHERN BLVD
Mailing Address - Street 2:STORE #6
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4316
Mailing Address - Country:US
Mailing Address - Phone:516-209-4970
Mailing Address - Fax:516-209-4971
Practice Address - Street 1:136 NORTHERN BLVD
Practice Address - Street 2:STORE #6
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4316
Practice Address - Country:US
Practice Address - Phone:516-209-4970
Practice Address - Fax:516-209-4971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032844333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy