MEDICARE: ABC 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	183500000X	Pharmacist	026818	NY
2	333600000X	Pharmacy	026818	NY

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
2	3339771	OTHER	NY	NABP NUMBER

General Provider Information

NPI Number	:	1437118510
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABC PHARMACY INC.

Provider Business Mailing Address
First Line	:	5401 8TH AVE STORE 'A'
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220
Country	:	US
Telephone Number	:	718-686-8830
Fax Number	:	718-686-8870

Provider Business Practice Location Address
First Line	:	5401 8TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220
Country	:	US
Telephone Number	:	718-686-8830
Fax Number	:	718-686-8870

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. HOK DOON JOHN AU
Credential	:
Telephone Number	:	347-680-6278

Provider Enumeration Date	:	03/19/2006
Last Update Date	:	03/07/2023

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