Healthcare Provider Details

I. General information

NPI: 1821272725
Provider Name (Legal Business Name): A&S DRUG STORE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 12/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1043 HICKSVILLE RD
SEAFORD NY
11783-1327
US

IV. Provider business mailing address

1043 HICKSVILLE RD
SEAFORD NY
11783-1327
US

V. Phone/Fax

Practice location:
  • Phone: 516-735-2094
  • Fax: 516-735-2092
Mailing address:
  • Phone: 516-735-2094
  • Fax: 516-735-2092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number18074
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number18074
License Number StateNY

VIII. Authorized Official

Name: MR. AMIN M LADHA
Title or Position: PRESIDENT
Credential:
Phone: 516-735-2094