Organization
NISAR PHARMACY INC
Active
Other names
NISAR PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
IBRAHIM KHAN (PRESIDENT)
(718) 402-9104
Entity
Organization
Contact information
Practice address
253B E 149TH ST, BRONX, NY 10451-5503
(718) 402-9104
(718) 665-8255
Mailing address
253B E 149TH ST, BRONX, NY 10451-5503
(718) 402-9104
(718) 665-8255
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
021733
NY
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01447194
—
NY
01
—
2064044
PK
—
Enumeration date
03/15/2007
Last updated
03/13/2021
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