MEDICARE: LA ALTAGRACIA 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
1	333600000X	Pharmacy

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	:	1316086952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA ALTAGRACIA PHARMACY INC

Provider Business Mailing Address
First Line	:	1544 SAINT NICHOLAS AVE # A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10040-4506
Country	:	US
Telephone Number	:	212-795-5005
Fax Number	:	201-567-6744

Provider Business Practice Location Address
First Line	:	1544 SAINT NICHOLAS AVE # A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10040-4506
Country	:	US
Telephone Number	:	212-795-5005
Fax Number	:	201-567-6744

Authorized Official
Title or Position	:	SUPERVISING PHARMACIST
Name	:	NASREEN SHAUKAT RIZVI
Credential	:
Telephone Number	:	212-795-5004

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	06/22/2015

Similar Medicare Providers

1720595556 — NASREEN RIZVI SUPRV PHARMACIST
Practice Location Address:

1544A SAINT NICHOLAS AVE
NEW YORK, NY
10040-4506

Practice Phone: 212-795-5004
Practice Fax: 212-795-3466

1619605623 — MR. KENNETH L GRAVES (LMSW)
Practice Location Address:

826 COLUMBUS AVE APT 11G
NEW YORK, NY
10025-4506

Practice Phone: 212-837-2711
Practice Fax:

1689489908 — A LIFE TO LIVE HOME CARE LLC
Practice Location Address:

1518 S GEORGE ST
YORK, PA
17403-4506

Practice Phone: 717-727-0431
Practice Fax: 717-678-6967

1225155682 — BUCKS PHYSICAL & SPORTS REHABILITATION
Practice Location Address:

327 YORK RD
WARMINSTER, PA
18974-4506

Practice Phone: 215-672-7373
Practice Fax: 215-357-8499

1508245051 — JESSICA ELISABETH KELLER DPT
Practice Location Address:

327 YORK RD
WARMINSTER, PA
18974-4506

Practice Phone: 215-672-7373
Practice Fax: 215-672-7399

1073274387 — DE'TRECE ATALIE LAVENDER NCC. LCPC
Practice Location Address:

4904 YORK RD UNIT 4506
BALTIMORE, MD
21212-7501

Practice Phone: 240-565-0569
Practice Fax: 240-427-9390

Directions to “LA ALTAGRACIA PHARMACY INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.