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NPI Code Detail

MEDICARE: WEBSTER 123 PHARMACY INC

MEDICARE: WEBSTER 123 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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy033125NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22150766OTHERPK

General Provider Information

NPI Number : 1407263023
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEBSTER 123 PHARMACY INC
Provider Business Mailing Address
First Line : 1231 WEBSTER AVE
Second Line :
City : BRONX
State : NY
Zip : 10456-3373
Country : US
Telephone Number : 718-618-0802
Fax Number : 718-618-0804
Provider Business Practice Location Address
First Line : 1231 WEBSTER AVE
Second Line :
City : BRONX
State : NY
Zip : 10456-3373
Country : US
Telephone Number : 718-618-0802
Fax Number : 718-618-0804
Authorized Official
Title or Position : PRESIDENT
Name : AQEEL AHMED
Credential :
Telephone Number : 201-931-5900
Provider Enumeration Date : 07/15/2014
Last Update Date : 11/29/2016

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Directions to “WEBSTER 123 PHARMACY INC ” Practice Location

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