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General NPI Number Information
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NPI Number | 1023113677
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Entity Type | Organization
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Legal Business Name | MEACHAM PHARMACY
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | 107 MEACHAM AVE
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City | ELMONT
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State | NY
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Zip | 11003-2630
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Country | US
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Telephone | 516-354-2950
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Fax | 516-354-3375
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Provider Business Mailing Address
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Address Line | 107 MEACHAM AVE
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City | ELMONT
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State | NY
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Zip | 11003-2630
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Country | US
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Telephone | 516-354-2950
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Fax | 516-354-3375
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Authorized Official
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Title or Position | S P
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Name | LAURA BENINCASA
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Credential | R PH BS
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Telephone | 516-354-2950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 015262
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License Number State | NY
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