MEDICARE: AN NOOR 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
2	3336C0003X	Community/Retail Pharmacy	027912	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2068317	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568470193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AN NOOR PHARMACY INC

Provider Business Mailing Address
First Line	:	35 101ST AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-3404
Country	:	US
Telephone Number	:	718-827-4000
Fax Number	:	718-827-4001

Provider Business Practice Location Address
First Line	:	35 101ST AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-3404
Country	:	US
Telephone Number	:	718-827-4000
Fax Number	:	718-827-4001

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEPHANIE HUQ
Credential	:
Telephone Number	:	718-827-4000

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	12/01/2016

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Directions to “AN NOOR PHARMACY INC ” Practice Location

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