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General NPI Number Information
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NPI Number | 1093858730
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Entity Type | Organization
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Legal Business Name | SKYPAN PHARMACIES INC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11112 MERRICK BLVD
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City | JAMAICA
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State | NY
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Zip | 11433-4016
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Country | US
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Telephone | 718-657-7272
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Fax |
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Provider Business Mailing Address
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Address Line | 11112 MERRICK BLVD
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City | JAMAICA
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State | NY
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Zip | 11433-4016
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Country | US
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Telephone | 718-657-7272
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Fax |
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Authorized Official
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Title or Position | SUPERVISIN PHARMACIST
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Name | NATACHA AUGUSTIN
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Credential | RPH
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Telephone | 718-657-7272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 023852
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License Number State | NY
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