MEDICARE: CARE FIRST PHARMACY 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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	035150	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2166966	OTHER		PK

General Provider Information

NPI Number	:	1861936338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE FIRST PHARMACY CORP

Provider Business Mailing Address
First Line	:	3908A WHITE PLAINS RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-3018
Country	:	US
Telephone Number	:	718-676-5959
Fax Number	:	718-676-5899

Provider Business Practice Location Address
First Line	:	3908A WHITE PLAINS RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-3018
Country	:	US
Telephone Number	:	718-676-5959
Fax Number	:	718-676-5899

Authorized Official
Title or Position	:	SP
Name	:	MARIAM IBRAHIM
Credential	:
Telephone Number	:	718-316-7189

Provider Enumeration Date	:	12/18/2016
Last Update Date	:	02/28/2017

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Directions to “CARE FIRST PHARMACY CORP ” Practice Location

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