Provider Demographics
NPI:1487479549
Name:YMGA PHARMACY SERVICES, CORP
Entity type:Organization
Organization Name:YMGA PHARMACY SERVICES, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTON
Authorized Official - Middle Name:
Authorized Official - Last Name:FALLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-680-9855
Mailing Address - Street 1:8510 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-4610
Mailing Address - Country:US
Mailing Address - Phone:718-680-9855
Mailing Address - Fax:
Practice Address - Street 1:8510 3RD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-4610
Practice Address - Country:US
Practice Address - Phone:718-680-9855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YMGA PHARMACY SERVICES, CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy