Provider Demographics
NPI:1528703154
Name:PK PHARMA LLC
Entity type:Organization
Organization Name:PK PHARMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PEYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMASI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-642-4070
Mailing Address - Street 1:7101 N MESA ST STE 537
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3613
Mailing Address - Country:US
Mailing Address - Phone:915-642-4070
Mailing Address - Fax:915-642-4071
Practice Address - Street 1:6898 DONIPHAN DR STE A
Practice Address - Street 2:
Practice Address - City:CANUTILLO
Practice Address - State:TX
Practice Address - Zip Code:79835-5401
Practice Address - Country:US
Practice Address - Phone:915-642-4070
Practice Address - Fax:915-642-4071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy