Healthcare Provider Details

I. General information

NPI: 1528213246
Provider Name (Legal Business Name): NATIONAL SPECIALITY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2008
Last Update Date: 01/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1336 PENINSULA BLVD
HEWLETT NY
11557-1226
US

IV. Provider business mailing address

1336 PENINSULA BLVD
HEWLETT NY
11557-1226
US

V. Phone/Fax

Practice location:
  • Phone: 516-791-6700
  • Fax: 516-791-8324
Mailing address:
  • Phone: 516-791-6700
  • Fax: 516-791-8324

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 TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number029156
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NINO CARNOVALE
Title or Position: OWNER
Credential:
Phone: 516-791-6700