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NPI Code Detail

MEDICARE: PITKIN EXPRESS CARE PHARMACY INC

MEDICARE: PITKIN EXPRESS 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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy035295NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12167323OTHERPK

General Provider Information

NPI Number : 1821534694
Entity Type Code : Organization
Provider Name (Legal Business Name) : PITKIN EXPRESS CARE PHARMACY INC
Provider Business Mailing Address
First Line : 1672 PITKIN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11212-5605
Country : US
Telephone Number : 347-627-4778
Fax Number : 347-627-4779
Provider Business Practice Location Address
First Line : 1672 PITKIN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11212-5605
Country : US
Telephone Number : 347-627-4778
Fax Number : 347-627-4779
Authorized Official
Title or Position : PRESIDENT
Name : EDUARD RUBINOV
Credential :
Telephone Number : 347-627-4778
Provider Enumeration Date : 01/17/2017
Last Update Date : 04/19/2017

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Directions to “PITKIN EXPRESS CARE PHARMACY INC ” Practice Location

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