MEDICARE: THE HEALTHCARE STORE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013941004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HEALTHCARE STORE, INC.

Provider Business Mailing Address
First Line	:	126 E MAIN ST
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-8302
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	126 E MAIN ST
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-8302
Country	:	US
Telephone Number	:	631-666-8000
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. JANINE FINAN
Credential	:
Telephone Number	:	631-666-8000

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	08/22/2020

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Directions to “THE HEALTHCARE STORE, INC. ” Practice Location

Language	Start Address	Practice Location

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