Healthcare Provider Details

I. General information

NPI: 1982955613
Provider Name (Legal Business Name): LUCKY CARE PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2012
Last Update Date: 05/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 PRINCE ST # 1A
FLUSHING NY
11354-4429
US

IV. Provider business mailing address

3720 PRINCE ST # 1A
FLUSHING NY
11354-4429
US

V. Phone/Fax

Practice location:
  • Phone: 718-358-7000
  • Fax: 718-358-7008
Mailing address:
  • Phone: 718-358-7000
  • Fax: 718-358-7008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SHUNYU CHI
Title or Position: PRESIDENT
Credential:
Phone: 718-358-7000