Provider Demographics
NPI:1053592527
Name:NOOR PHARMACY INC
Entity type:Organization
Organization Name:NOOR PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHRAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-282-8982
Mailing Address - Street 1:2036 BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1905
Mailing Address - Country:US
Mailing Address - Phone:718-282-8982
Mailing Address - Fax:718-282-0428
Practice Address - Street 1:2036 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-1905
Practice Address - Country:US
Practice Address - Phone:718-282-8982
Practice Address - Fax:718-282-0428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X
NY0285733336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02933044Medicaid
3356804OtherNCPDP PROVIDER IDENTIFICATION NUMBER
3356804OtherNCPDP PROVIDER IDENTIFICATION NUMBER