Organization
PRANAM HEALTHCARE LLC
Active
Other names
San Pedro Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KRUNAL VASANI RPH (PHARMACY MANAGER/PIC/AO)
(212) 928-7263
Entity
Organization
Contact information
Practice address
1381 SAINT NICHOLAS AVE, NEW YORK, NY 10033-4001
(212) 928-7263
(917) 521-8307
Mailing address
1381 SAINT NICHOLAS AVE, NEW YORK, NY 10033-4001
(212) 928-7263
(917) 521-8307
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
033184
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2148092
PK
—
05
—
4131279
—
NY
Enumeration date
09/03/2014
Last updated
06/09/2016
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