MEDICARE: LIST DRUGS 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	3336C0003X	Community/Retail Pharmacy	018709	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3323449	OTHER	NY	NCPDP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043351638
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIST DRUGS INC.

Provider Business Mailing Address
First Line	:	1709 AVENUE M
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-5303
Country	:	US
Telephone Number	:	718-339-4483
Fax Number	:	718-336-8789

Provider Business Practice Location Address
First Line	:	1709 AVENUE M
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-5303
Country	:	US
Telephone Number	:	718-339-4483
Fax Number	:	718-336-8789

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. STEVEN ALAN HOFFMAN
Credential	:
Telephone Number	:	718-339-4483

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	03/04/2022

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