Healthcare Provider Details

I. General information

NPI: 1871506337
Provider Name (Legal Business Name): 353 EMPIRE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 UNION AVE
BROOKLYN NY
11211-1395
US

IV. Provider business mailing address

505 UNION AVE
BROOKLYN NY
11211-1395
US

V. Phone/Fax

Practice location:
  • Phone: 718-467-0918
  • Fax: 718-774-3078
Mailing address:
  • Phone: 718-467-0918
  • Fax: 718-774-3078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: NUCHEM JACOBOWITZ
Title or Position: OWNER
Credential:
Phone: 718-687-0497