Provider Demographics
NPI:1871134288
Name:GREENWAY HEALTH & PHARMACY INC
Entity type:Organization
Organization Name:GREENWAY HEALTH & PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YURIY
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLOKANDOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-527-1388
Mailing Address - Street 1:6547 99TH ST
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4347
Mailing Address - Country:US
Mailing Address - Phone:347-527-1388
Mailing Address - Fax:347-527-2898
Practice Address - Street 1:6547 99TH ST
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4347
Practice Address - Country:US
Practice Address - Phone:347-527-1388
Practice Address - Fax:347-527-2898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-07
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy