Provider Demographics
NPI:1396329538
Name:PHARAOHS TRADING L.L.C.
Entity type:Organization
Organization Name:PHARAOHS TRADING L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:GENDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-366-2016
Mailing Address - Street 1:743 S NOVA RD
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-7332
Mailing Address - Country:US
Mailing Address - Phone:386-366-2016
Mailing Address - Fax:
Practice Address - Street 1:743 S NOVA RD
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-7332
Practice Address - Country:US
Practice Address - Phone:386-366-2016
Practice Address - Fax:386-238-9845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies