MEDICARE: OCEAN-U 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
1	333600000X	Pharmacy	026984	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

General Provider Information

NPI Number	:	1669432274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEAN-U PHARMACY, LLC

Provider Business Mailing Address
First Line	:	2001 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3907
Country	:	US
Telephone Number	:	718-332-3380
Fax Number	:	718-332-2638

Provider Business Practice Location Address
First Line	:	2001 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3907
Country	:	US
Telephone Number	:	718-332-3380
Fax Number	:	718-332-2638

Authorized Official
Title or Position	:	SUPERVISING PHARMACIST
Name	:	MS. JENNY CHEUNG
Credential	:	RPH
Telephone Number	:	718-332-3380

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	08/22/2020

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