Healthcare Provider Details

I. General information

NPI: 1013014950
Provider Name (Legal Business Name): NATURES APOTHECARY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 01/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1612 E 16TH ST
BROOKLYN NY
11229-1108
US

IV. Provider business mailing address

1612 E 16TH ST
BROOKLYN NY
11229-1108
US

V. Phone/Fax

Practice location:
  • Phone: 718-375-7877
  • Fax: 718-382-5445
Mailing address:
  • Phone: 718-375-7877
  • Fax: 718-382-5445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number025612
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOHN AZARELLI
Title or Position: PRESIDENT
Credential:
Phone: 718-375-7877