MEDICARE: MERRICK APOTHECARY CORP.

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1740857879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERRICK APOTHECARY CORP.

Provider Business Mailing Address
First Line	:	2027 MERRICK RD
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-4703
Country	:	US
Telephone Number	:	516-581-1037
Fax Number	:

Provider Business Practice Location Address
First Line	:	2027 MERRICK RD
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-4703
Country	:	US
Telephone Number	:	516-684-9732
Fax Number	:	516-684-9817

Authorized Official
Title or Position	:	OWNER
Name	:	BRIAN ZONE
Credential	:
Telephone Number	:	516-581-1037

Provider Enumeration Date	:	06/08/2021
Last Update Date	:	09/05/2021

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Directions to “MERRICK APOTHECARY CORP. ” Practice Location

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