Provider Demographics
NPI:1063431161
Name:RICKCO DRUGS INC.
Entity type:Organization
Organization Name:RICKCO DRUGS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:EKRAMUL
Authorized Official - Last Name:HAQUE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-267-9498
Mailing Address - Street 1:30100 51ST ST
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-1457
Mailing Address - Country:US
Mailing Address - Phone:718-267-9498
Mailing Address - Fax:718-267-9499
Practice Address - Street 1:30100 51ST ST
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-1457
Practice Address - Country:US
Practice Address - Phone:718-267-9498
Practice Address - Fax:718-267-9499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
NY021527333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01381906Medicaid
33-28641OtherNCPDP
BR3458507OtherDEA