MEDICARE: THEONIS 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	027333	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	3347021	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1588753131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THEONIS PHARMACY INC

Provider Business Mailing Address
First Line	:	2465 GRAND CONCOURSE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-5443
Country	:	US
Telephone Number	:	718-220-7555
Fax Number	:	718-220-7552

Provider Business Practice Location Address
First Line	:	2465 GRAND CONCOURSE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-5443
Country	:	US
Telephone Number	:	718-220-7555
Fax Number	:	718-220-7552

Authorized Official
Title or Position	:	MGR
Name	:	GEORGE MITSOPOULOS
Credential	:
Telephone Number	:	718-220-7555

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	08/08/2011

Similar Medicare Providers

1013171149 — PRO OPTICS CORP
Practice Location Address:

2483 GRAND CONCOURSE
BRONX, NY
10468-5443

Practice Phone: 718-933-0187
Practice Fax:

1275771248 — SUPERIOR DENTAL
Practice Location Address:

2475 GRAND CONCOURSE
BRONX, NY
10468-5443

Practice Phone: 718-329-2929
Practice Fax: 718-329-2930

1609559418 — RACHEL GOHARI
Practice Location Address:

2483 GRAND CONCOURSE
BRONX, NY
10468-5443

Practice Phone: 718-933-0187
Practice Fax:

1285055665 — URBAN HEALTH PLAN, INC.
Practice Location Address:

800 HOME ST
BRONX, NY
10456-5443

Practice Phone: 917-962-9337
Practice Fax:

1073192886 — CRISTAL CASTILLO LCSW
Practice Location Address:

2685 UNIVERSITY AVE APT 61C
BRONX, NY
10468-3362

Practice Phone: 929-548-2540
Practice Fax:

1528889268 — DIYA KHAN
Practice Location Address:

2545 SEDGWICK AVE APT 1C
BRONX, NY
10468-3802

Practice Phone: 718-926-9975
Practice Fax:

Directions to “THEONIS 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.