MEDICARE: NEW CENTURY 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	033238	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2149218	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740687979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW CENTURY PHARMACY INC

Provider Business Mailing Address
First Line	:	6352 108TH ST
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-1350
Country	:	US
Telephone Number	:	917-832-6494
Fax Number	:	917-832-6495

Provider Business Practice Location Address
First Line	:	6352 108TH ST
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-1350
Country	:	US
Telephone Number	:	917-832-6494
Fax Number	:	917-832-6495

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EDUARD ARONOV
Credential	:
Telephone Number	:	917-832-6494

Provider Enumeration Date	:	12/03/2014
Last Update Date	:	08/12/2016

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