Healthcare Provider Details

I. General information

NPI: 1265996334
Provider Name (Legal Business Name): BEYOND HEALTH PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2019
Last Update Date: 07/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 THIRD AVE
NEW YORK NY
10003-2506
US

IV. Provider business mailing address

205 THIRD AVE
NEW YORK NY
10003-2506
US

V. Phone/Fax

Practice location:
  • Phone: 212-477-7788
  • Fax: 212-477-7789
Mailing address:
  • Phone: 212-477-7788
  • Fax: 212-477-7789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID Z KUNIN
Title or Position: PRESIDENT
Credential: PHARMD
Phone: 212-470-8345