MEDICARE: EXPEDITE CARE 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	332B00000X	Durable Medical Equipment & Medical Supplies		NY
2	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1669798047
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXPEDITE CARE PHARMACY, INC.

Provider Business Mailing Address
First Line	:	2283 NOSTRAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-3839
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2283 NOSTRAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-3839
Country	:	US
Telephone Number	:	646-359-1976
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	DR. ESDRAS OBAS
Credential	:	PHARM D.
Telephone Number	:	646-359-1976

Provider Enumeration Date	:	04/11/2010
Last Update Date	:	01/24/2013

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