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NPI Code Detail

MEDICARE: MARINE PHARMACY INC

MEDICARE: MARINE PHARMACY 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
13336C0003XCommunity/Retail Pharmacy

Other Identifiers

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

General Provider Information

NPI Number : 1235298795
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARINE PHARMACY INC
Provider Business Mailing Address
First Line : 2758 GERRITSEN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-5915
Country : US
Telephone Number : 718-332-7155
Fax Number : 718-648-5482
Provider Business Practice Location Address
First Line : 2758 GERRITSEN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-5915
Country : US
Telephone Number : 718-332-7155
Fax Number : 718-648-5482
Authorized Official
Title or Position : PRESIDENT
Name : NADINE DANDAN
Credential :
Telephone Number : 718-332-7155
Provider Enumeration Date : 12/08/2006
Last Update Date : 10/27/2025

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