Provider Demographics
NPI:1992231989
Name:FOREST HILLS ORGANICS INC
Entity type:Organization
Organization Name:FOREST HILLS ORGANICS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ISKHAKOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-642-3779
Mailing Address - Street 1:11712 QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-7052
Mailing Address - Country:US
Mailing Address - Phone:718-487-3570
Mailing Address - Fax:718-487-3691
Practice Address - Street 1:11712 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-7052
Practice Address - Country:US
Practice Address - Phone:718-487-3570
Practice Address - Fax:718-487-3691
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PALMYRA EQUITY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035463333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy