Organization
FANCY PHARMACY INC
Active
Other names
Fancy Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
RAFIN RASHID (PRESIDENT)
(516) 398-1284
Entity
Organization
Contact information
Practice address
2158 STARLING AVE, BRONX, NY 10462-4303
(718) 892-5140
(718) 892-5141
Mailing address
2158 STARLING AVE, BRONX, NY 10462-4303
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
029005
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3358517
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/28/2008
Last updated
01/12/2009
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