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NPI Code Detail

MEDICARE: MIEL PHARMACY CORP

MEDICARE: MIEL PHARMACY CORP
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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy025984NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22059858OTHERPK

General Provider Information

NPI Number : 1225125420
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIEL PHARMACY CORP
Provider Business Mailing Address
First Line : 8617 5TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-5201
Country : US
Telephone Number : 718-759-9500
Fax Number : 718-759-1411
Provider Business Practice Location Address
First Line : 8617 5TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-5201
Country : US
Telephone Number : 718-759-9500
Fax Number : 718-759-1411
Authorized Official
Title or Position : PRES
Name : IGOR MOSHCHINSKY
Credential :
Telephone Number : 718-759-9500
Provider Enumeration Date : 10/07/2006
Last Update Date : 04/17/2013

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