MEDICARE: EUREKA LABORATORIES 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	025353	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3326700	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1932141462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EUREKA LABORATORIES INC

Provider Business Mailing Address
First Line	:	9 WALNUT DR
Second Line	:
City	:	SYOSSET
State	:	NY
Zip	:	11791-4716
Country	:	US
Telephone Number	:	516-364-3799
Fax Number	:

Provider Business Practice Location Address
First Line	:	894 6TH AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-3508
Country	:	US
Telephone Number	:	212-695-4232
Fax Number	:	212-695-8658

Authorized Official
Title or Position	:	SP OWNER
Name	:	YONG KIM
Credential	:
Telephone Number	:	212-695-4232

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	08/23/2011

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Directions to “EUREKA LABORATORIES INC ” Practice Location

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