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General NPI Number Information
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NPI Number | 1164971818
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Entity Type | Organization
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Legal Business Name | ISLAND DRUGS LLC
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Dates
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Enumeration Date | 09/22/2016
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Last Update Date | 06/30/2017
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Provider Practice Location Address
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Address Line | 336 N BROADWAY PHARMACY DEPT
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City | JERICHO
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State | NY
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Zip | 11753-2031
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Country | US
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Telephone | 516-490-5595
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Fax | 516-490-5594
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Provider Business Mailing Address
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Address Line | PO BOX 43
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City | OLD BETHPAGE
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State | NY
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Zip | 11804-0043
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Country | US
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Telephone | 516-490-5595
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Fax | 516-490-5594
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Authorized Official
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Title or Position | PHARMACIST
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Name | JOAN YIU
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Credential |
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Telephone | 516-490-5595
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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 | 035008
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License Number State | NY
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