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NPI Code Detail

MEDICARE: MILL PARK DRUGS INC

MEDICARE: MILL PARK DRUGS 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
1333600000XPharmacy016203NY

Other Identifiers

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

General Provider Information

NPI Number : 1679676159
Entity Type Code : Organization
Provider Name (Legal Business Name) : MILL PARK DRUGS INC
Provider Business Mailing Address
First Line : 3948 RICHMOND AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10312-5111
Country : US
Telephone Number : 718-356-1789
Fax Number : 718-356-1777
Provider Business Practice Location Address
First Line : 3948 RICHMOND AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10312-5111
Country : US
Telephone Number : 718-356-1789
Fax Number : 718-356-1777
Authorized Official
Title or Position : OWNER
Name : SILVANA MATTIDI
Credential :
Telephone Number : 715-356-1789
Provider Enumeration Date : 09/07/2006
Last Update Date : 09/03/2019

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Directions to “MILL PARK DRUGS INC ” Practice Location

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