Provider Demographics
NPI:1669258323
Name:PHARMA CORP
Entity type:Organization
Organization Name:PHARMA CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-597-3540
Mailing Address - Street 1:2927 NEWTOWN AVE # STOREB
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-2128
Mailing Address - Country:US
Mailing Address - Phone:347-507-0180
Mailing Address - Fax:347-507-0295
Practice Address - Street 1:2927 NEWTOWN AVE # STOREB
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2128
Practice Address - Country:US
Practice Address - Phone:347-507-0180
Practice Address - Fax:347-507-0295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-07
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy