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General NPI Number Information
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NPI Number | 1235124009
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Entity Type | Organization
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Legal Business Name | MERRICK DRUGS INC.
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Dates
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Enumeration Date | 09/16/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2013 MERRICK RD
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City | MERRICK
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State | NY
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Zip | 11566-4644
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Country | US
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Telephone | 516-379-5446
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Fax | 516-379-5859
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Provider Business Mailing Address
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Address Line | 2013 MERRICK RD
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City | MERRICK
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State | NY
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Zip | 11566-4644
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Country | US
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Telephone | 516-379-5446
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Fax | 516-379-5859
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. STELLA MAKSUMOVA
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Credential | RPH
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Telephone | 516-379-5446
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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 | 024681
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License Number State | NY
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