MEDICARE: H&R NYC PHARMACEUTICAL LLC

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

General Provider Information

NPI Number	:	1174088348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H&R NYC PHARMACEUTICAL LLC

Provider Business Mailing Address
First Line	:	1265 CLOVE RD # STOREE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10301-4339
Country	:	US
Telephone Number	:	347-922-3924
Fax Number	:

Provider Business Practice Location Address
First Line	:	1265 CLOVE RD # STOREE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10301-4339
Country	:	US
Telephone Number	:	347-922-3924
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HAIDER ABBAS
Credential	:
Telephone Number	:	347-922-3924

Provider Enumeration Date	:	02/01/2019
Last Update Date	:	10/29/2020

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