Provider Demographics
NPI:1679845267
Name:NEW FLUSHING PHARMACY INCORPORATED
Entity type:Organization
Organization Name:NEW FLUSHING PHARMACY INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-368-6681
Mailing Address - Street 1:4207 KISSENA BLVD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3275
Mailing Address - Country:US
Mailing Address - Phone:347-368-6681
Mailing Address - Fax:347-368-6560
Practice Address - Street 1:4207 KISSENA BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3275
Practice Address - Country:US
Practice Address - Phone:347-368-6681
Practice Address - Fax:347-368-6560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
NY0310943336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5804364OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NY6679860001Medicare NSC