=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255120051
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMET PHARMACY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/06/2025
-----------------------------------------------------
Last Update Date | 05/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2302 BELLMORE AVE
-----------------------------------------------------
City | BELLMORE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11710-5627
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-654-9563
-----------------------------------------------------
Fax | 877-284-9758
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2302 BELLMORE AVE
-----------------------------------------------------
City | BELLMORE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11710-5627
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-654-9563
-----------------------------------------------------
Fax | 877-284-9758
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACY MANAGER
-----------------------------------------------------
Name | SEBASTIAN MUSA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 516-654-9562
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------