MEDICARE: HYOSHIM 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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1922816685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HYOSHIM PHARMACY INC

Provider Business Mailing Address
First Line	:	3A BOND ST
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-2408
Country	:	US
Telephone Number	:	516-304-5893
Fax Number	:

Provider Business Practice Location Address
First Line	:	3A BOND ST
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-2408
Country	:	US
Telephone Number	:	516-304-5893
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JUNGUK LEE TO
Credential	:
Telephone Number	:	516-304-5893

Provider Enumeration Date	:	12/26/2024
Last Update Date	:	12/26/2024

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Directions to “HYOSHIM PHARMACY INC ” Practice Location

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