Healthcare Provider Details

I. General information

NPI: 1962586099
Provider Name (Legal Business Name): BELLMORE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 BEDFORD AVE
BELLMORE NY
11710-3526
US

IV. Provider business mailing address

111 BEDFORD AVE
BELLMORE NY
11710-3526
US

V. Phone/Fax

Practice location:
  • Phone: 516-221-4022
  • Fax: 516-221-4029
Mailing address:
  • Phone: 516-221-4022
  • Fax: 516-221-4029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number026500
License Number StateNY

VIII. Authorized Official

Name: SAURABH SHETH
Title or Position: OWNER/RPH
Credential: RPH
Phone: 516-221-4022