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NPI Code Detail

MEDICARE: FOREST PHARMACY LLC

MEDICARE: FOREST PHARMACY LLC
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 Pharmacy030699NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22130333OTHERPK

General Provider Information

NPI Number : 1588956262
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOREST PHARMACY LLC
Provider Business Mailing Address
First Line : 2236 FOREST AVE
Second Line : SUITE # 5
City : STATEN ISLAND
State : NY
Zip : 10303-1747
Country : US
Telephone Number : 718-447-5900
Fax Number : 718-447-5902
Provider Business Practice Location Address
First Line : 2236 FOREST AVE STE 5
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10303-1714
Country : US
Telephone Number : 718-447-5900
Fax Number : 718-447-5902
Authorized Official
Title or Position : SUPERVISING PHARMACIST / MEMBE
Name : DARSHANKUMAR BHATT
Credential :
Telephone Number : 718-447-5900
Provider Enumeration Date : 05/12/2011
Last Update Date : 10/12/2016

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Directions to “FOREST PHARMACY LLC ” Practice Location

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