Provider Demographics
NPI:1437254844
Name:AUSTRA LINE PHARMACY INC
Entity type:Organization
Organization Name:AUSTRA LINE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHINEDU
Authorized Official - Middle Name:M
Authorized Official - Last Name:AGBASIONWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-531-6000
Mailing Address - Street 1:PO BOX 340250
Mailing Address - Street 2:5916 GLENWOOD ROAD
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234
Mailing Address - Country:US
Mailing Address - Phone:718-531-6000
Mailing Address - Fax:718-531-6004
Practice Address - Street 1:5916 GLENWOOD ROAD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234
Practice Address - Country:US
Practice Address - Phone:718-531-6000
Practice Address - Fax:718-531-6004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027830183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty