Healthcare Provider Details

I. General information

NPI: 1285541706
Provider Name (Legal Business Name): MEDURA HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 W OLD COUNTRY RD
HICKSVILLE NY
11801-4011
US

IV. Provider business mailing address

100 DUFFY AVE STE 510
HICKSVILLE NY
11801-3636
US

V. Phone/Fax

Practice location:
  • Phone: 631-813-4500
  • Fax: 631-813-4500
Mailing address:
  • Phone: 631-813-4500
  • Fax: 631-813-4500

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: MR. SANJEEV KUMAR
Title or Position: MANAGER
Credential:
Phone: 631-813-4500