Healthcare Provider Details

I. General information

NPI: 1255409983
Provider Name (Legal Business Name): TOTAL CARE PHARMACY XI INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 04/21/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2859 ROUTE 55
POUGHQUAG NY
12570-5619
US

IV. Provider business mailing address

2859 ROUTE 55
POUGHQUAG NY
12570-5619
US

V. Phone/Fax

Practice location:
  • Phone: 845-724-5757
  • Fax: 845-724-2299
Mailing address:
  • Phone: 845-724-5757
  • Fax: 845-724-2299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number027106
License Number StateNY

VIII. Authorized Official

Name: KAZI FALGUNI
Title or Position: PRESIDENT
Credential:
Phone: 845-724-5757