Healthcare Provider Details

I. General information

NPI: 1396282141
Provider Name (Legal Business Name): THROOP PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2017
Last Update Date: 04/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 THROOP AVE
BROOKLYN NY
11206-6611
US

IV. Provider business mailing address

241 THROOP AVE
BROOKLYN NY
11206-6611
US

V. Phone/Fax

Practice location:
  • Phone: 718-484-3361
  • Fax: 718-484-3362
Mailing address:
  • Phone: 718-484-3361
  • Fax: 718-484-3362

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 Number035171
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GENADY MAYZEL
Title or Position: PRESIDENT
Credential:
Phone: 718-484-3361