Organization
IMAN PHARMACY INC
Active
Other names
FLEETWOOD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARWAN ABDULLAH R.PH (PRESIDENT / PIC)
(914) 665-5556
Entity
Organization
Contact information
Practice address
505 GRAMATAN AVE, MOUNT VERNON, NY 10552-3008
(914) 665-5556
(914) 665-5589
Mailing address
505 GRAMATAN AVE, MOUNT VERNON, NY 10552-3008
(914) 665-5556
(914) 665-5589
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
027817
NY
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02785711
—
NY
01
—
2068108
PK
—
Enumeration date
05/24/2006
Last updated
03/18/2015
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