Organization
PAAK PHARMACY INC
Active
Other names
112 PHARMACY & SURGICAL
Organization subpart
No
Provider details
NPI number
Authorized official
RAJENDRAPRASAD VENIGALLA (SECRETARY)
(347) 528-8893
Entity
Organization
Contact information
Practice address
689 MEDFORD AVE, PATCHOGUE, NY 11772-1347
(631) 289-2468
(631) 307-9360
Mailing address
689 MEDFORD AVE, PATCHOGUE, NY 11772-1347
(631) 289-2468
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
033702
NY
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04601929
—
NY
01
—
2153923
PK
—
Enumeration date
09/03/2015
Last updated
01/27/2021
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