Healthcare Provider Details

I. General information

NPI: 1093013930
Provider Name (Legal Business Name): CARE FIRST PHARMACY & SURGICAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2011
Last Update Date: 04/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5612A 8TH AVE
BROOKLYN NY
11220-3518
US

IV. Provider business mailing address

5612A 8TH AVE
BROOKLYN NY
11220-3518
US

V. Phone/Fax

Practice location:
  • Phone: 718-567-3338
  • Fax: 718-567-8887
Mailing address:
  • Phone: 718-567-3338
  • Fax: 718-567-8887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number030559
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number030559
License Number StateNY

VIII. Authorized Official

Name: DR. VINCENT WONG
Title or Position: SUPERVISING PHARMACIST
Credential: PHARMD
Phone: 718-567-3338