Healthcare Provider Details

I. General information

NPI: 1295028991
Provider Name (Legal Business Name): AVE Z PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2011
Last Update Date: 11/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 SHEEPSHEAD BAY RD
BROOKLYN NY
11235-3920
US

IV. Provider business mailing address

1324 SHEEPSHEAD BAY RD
BROOKLYN NY
11235-3920
US

V. Phone/Fax

Practice location:
  • Phone: 718-332-7733
  • Fax: 718-332-2971
Mailing address:
  • Phone: 718-332-7733
  • Fax: 718-332-2971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number030808
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336M0003X
TaxonomyManaged Care Organization Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: INEL LEVIYEVA
Title or Position: PHARMACIST
Credential:
Phone: 718-332-7733