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General NPI Number Information
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NPI Number | 1235308362
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Entity Type | Individual
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Provider Name | CHURK H LUI PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 02/22/2008
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Last Update Date | 02/22/2008
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Provider Practice Location Address
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Address Line | 403 ATLANTIC AVENUE
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City | FREEPORT
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State | NY
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Zip | 11520
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Country | US
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Telephone | 516-378-9720
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Fax |
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Provider Business Mailing Address
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Address Line | 2207 JACQUELINE AVE
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City | NORTH BELLMORE
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State | NY
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Zip | 11710-1034
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Country | US
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Telephone | 516-679-0552
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 31805
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License Number State | NY
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