Provider Demographics
NPI:1386731560
Name:KINGS HWY PHARMACY AND MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:KINGS HWY PHARMACY AND MEDICAL SUPPLY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOYKHET
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-375-5757
Mailing Address - Street 1:1671 EAST 13 STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1101
Mailing Address - Country:US
Mailing Address - Phone:718-375-5757
Mailing Address - Fax:718-375-0364
Practice Address - Street 1:1671 EAST 13 STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1101
Practice Address - Country:US
Practice Address - Phone:718-375-5757
Practice Address - Fax:718-375-0364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027329183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty