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NPI Code Detail

MEDICARE: UPTOWN CARE PHARMACY LLC

MEDICARE: UPTOWN CARE PHARMACY LLC
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 Pharmacy034563NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12160647OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841640653
Entity Type Code : Organization
Provider Name (Legal Business Name) : UPTOWN CARE PHARMACY LLC
Provider Business Mailing Address
First Line : 2254 2ND AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10029-2268
Country : US
Telephone Number : 212-221-8355
Fax Number : 917-675-7703
Provider Business Practice Location Address
First Line : 2254 2ND AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10029-2268
Country : US
Telephone Number : 212-221-8355
Fax Number : 917-675-7703
Authorized Official
Title or Position : PHARMACIST
Name : MIRIAM ILYAICH
Credential :
Telephone Number : 212-221-8355
Provider Enumeration Date : 06/13/2016
Last Update Date : 04/17/2017

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