Provider Demographics
NPI:1285328344
Name:FRESH MEADOW PHARMACY INC
Entity type:Organization
Organization Name:FRESH MEADOW PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:YUN HAI
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-290-9353
Mailing Address - Street 1:18408 HORACE HARDING EXPY
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-2124
Mailing Address - Country:US
Mailing Address - Phone:718-290-9353
Mailing Address - Fax:718-290-9354
Practice Address - Street 1:18408 HORACE HARDING EXPY
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-2124
Practice Address - Country:US
Practice Address - Phone:718-260-9353
Practice Address - Fax:718-260-9354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-02
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy