Healthcare Provider Details

I. General information

NPI: 1497842694
Provider Name (Legal Business Name): SAFETY DRUGS OF BENSONHURST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2006
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6404 18TH AVE
BROOKLYN NY
11204-3729
US

IV. Provider business mailing address

6404 18TH AVE
BROOKLYN NY
11204-3729
US

V. Phone/Fax

Practice location:
  • Phone: 718-236-5705
  • Fax: 718-234-0961
Mailing address:
  • Phone: 718-236-5705
  • Fax: 718-234-0961

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 Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number017831
License Number StateNY

VIII. Authorized Official

Name: MR. MICHAEL PETRATOS
Title or Position: VP
Credential: RPH
Phone: 718-236-5705