Healthcare Provider Details
I. General information
NPI: 1740104694
Provider Name (Legal Business Name): MEDICINE DEPOT INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
86 MANHATTAN AVE
BROOKLYN NY
11206-2501
US
IV. Provider business mailing address
86 MANHATTAN AVE
BROOKLYN NY
11206-2501
US
V. Phone/Fax
- Phone: 718-963-3923
- Fax: 718-963-3931
- Phone: 718-963-3923
- Fax: 718-963-3931
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JANARDHAN
SUNKAM
Title or Position: OWNER
Credential:
Phone: 718-963-3923