Healthcare Provider Details
I. General information
NPI: 1679266324
Provider Name (Legal Business Name): HEMPSTEAD CHEMIST INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/30/2023
Last Update Date: 06/26/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
86 N FRANKLIN ST
HEMPSTEAD NY
11550-3021
US
IV. Provider business mailing address
86 N FRANKLIN ST
HEMPSTEAD NY
11550-3021
US
V. Phone/Fax
- Phone: 516-292-2424
- Fax: 516-292-2442
- Phone: 516-292-2424
- Fax: 516-292-2442
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MICHAEL
KANDCHOROV
Title or Position: SUPERVISING PHARMACIST/OWNER
Credential: RPH
Phone: 347-567-5058