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Organization
MEDI-SPACE PHARMA INC
Active
Organization
MEDI-SPACE PHARMA INC
Active
Other names
MEDI-SPACE DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
HILTON CHEUNG (PRESIDENT)
(718) 961-3373
Entity
Organization
Contact information
Practice address
4139 MAIN ST, FLUSHING, NY 11355-3132
(718) 961-3373
(718) 961-3311
Mailing address
4139 MAIN ST, FLUSHING, NY 11355-3132
(718) 961-3373
(718) 961-3311
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
030843
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003108663
—
NY
05
—
3338492
—
NY
01
—
5803918
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/13/2011
Last updated
06/06/2016
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