112 Pharmacy & Surgical
LBN: Paak Pharmacy Inc
112 Pharmacy & Surgical is an health care organization with primary practice located at 689 Medford Ave , Patchogue NY 11772-1347. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Paak Pharmacy Inc can be contacted via phone (631) 289-2468, or through Venigalla, Rajendraprasad via phone (347) 528-8893.
Contact Information
Primary practice address
689 Medford Ave
Patchogue NY 11772-1347
Phone: (631) 289-2468
Fax: (631) 307-9360
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 033702 | New York |
| Suppliers / Long Term Care Pharmacy | 3336L0003X |
Profile Details
| NPI number | 1780052001 |
|---|---|
| LBN Legal business name | Paak Pharmacy Inc |
| DBA Doing business as | 112 Pharmacy & Surgical |
| Authorized official | Venigalla, Rajendraprasad |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 3rd, 2015 |
| Last updated | Jan 27th, 2021 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780052001 | NPPES |
| New York | MEDICAID | 04601929 | |
| New York | Other | 2153923 |
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