Provider Demographics
NPI:1720803604
Name:PURECARE PHARMACY CORP
Entity type:Organization
Organization Name:PURECARE PHARMACY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:419-329-8825
Mailing Address - Street 1:8409 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-4709
Mailing Address - Country:US
Mailing Address - Phone:347-492-0211
Mailing Address - Fax:347-492-0085
Practice Address - Street 1:8409 5TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-4709
Practice Address - Country:US
Practice Address - Phone:347-492-0211
Practice Address - Fax:347-492-0085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy