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General NPI Number Information
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NPI Number | 1134435886
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Entity Type | Organization
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Legal Business Name | EMBLEM HEALTH PHARMACY
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Dates
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Enumeration Date | 08/19/2010
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Last Update Date | 03/24/2012
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Provider Practice Location Address
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Address Line | 1070 WASHINGTON AVE
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City | WESTBURY
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State | NY
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Zip | 11590-5533
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Country | US
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Telephone | 516-997-5260
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Fax |
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Provider Business Mailing Address
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Address Line | 1070 WASHINGTON AVE
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City | WESTBURY
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State | NY
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Zip | 11590-5533
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | ELISE ENCARNACION
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Credential | PHARMD
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Telephone | 516-997-5260
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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 | 054733
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License Number State | NY
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