Provider Demographics
NPI:1669724092
Name:DRUGTOWN PHARMACY INC.
Entity type:Organization
Organization Name:DRUGTOWN PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHAREHOLDER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FATA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-793-6747
Mailing Address - Street 1:10121 METROPOLITAN AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-6647
Mailing Address - Country:US
Mailing Address - Phone:718-793-6747
Mailing Address - Fax:718-793-6748
Practice Address - Street 1:10121 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-6647
Practice Address - Country:US
Practice Address - Phone:718-793-6747
Practice Address - Fax:718-793-6748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy