Organization
PANTAK INC.
Active
Other names
Hill Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK FOTAKIS RPH (PRESIDENT)
(718) 429-4646
Entity
Organization
Contact information
Practice address
53-82 65TH PLACE, MASPETH, NY 11378-1654
(718) 429-4646
(718) 335-4421
Mailing address
53-82 65TH PLACE, MASPETH, NY 11378-1654
(718) 429-4646
(718) 335-4421
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
022664
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01569153
—
NY
01
—
3373874
NCPDP #
NY
Enumeration date
06/24/2006
Last updated
06/04/2015
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