Healthcare Provider Details

I. General information

NPI: 1447090600
Provider Name (Legal Business Name): PURECARE PHARMACY AND WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2024
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 GLEN COVE RD
GREENVALE NY
11548-1007
US

IV. Provider business mailing address

65 GLEN COVE RD
GREENVALE NY
11548-1007
US

V. Phone/Fax

Practice location:
  • Phone: 914-330-1499
  • Fax:
Mailing address:
  • Phone: 914-330-1499
  • Fax:

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 Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. TOM AMIGDALOS
Title or Position: PRESIDENT
Credential: RPH
Phone: 516-277-2668