Healthcare Provider Details

I. General information

NPI: 1194814889
Provider Name (Legal Business Name): CAMY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14410 45TH AVE
FLUSHING NY
11355-2232
US

IV. Provider business mailing address

14410 45TH AVE
FLUSHING NY
11355-2232
US

V. Phone/Fax

Practice location:
  • Phone: 718-461-4452
  • Fax: 718-461-9899
Mailing address:
  • Phone: 718-461-4452
  • Fax: 718-461-9899

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 Number022206
License Number StateNY

VIII. Authorized Official

Name: VYOMESH SHAH
Title or Position: SP
Credential:
Phone: 718-461-4452