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NPI 1386741221

NPI 1386741221 : CROWN CHEMISTS LTD : ASTORIA, NY

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General NPI Number Information
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    NPI Number           |    1386741221
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    Entity Type          |    Organization 
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    Legal Business Name  |    CROWN CHEMISTS LTD 
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Dates
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    Enumeration Date     |    09/20/2006
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    Last Update Date     |    12/17/2012
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Provider Practice Location Address
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    Address Line         |    3320 DITMARS BLVD 
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    City                 |    ASTORIA
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    State                |    NY
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    Zip                  |    11105-2106
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    Country              |    US
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    Telephone            |    718-278-6777
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    Fax                  |    718-278-8716
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Provider Business Mailing Address
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    Address Line         |    3320 DITMARS BLVD 
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    City                 |    ASTORIA
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    State                |    NY
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    Zip                  |    11105-2106
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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    |    SUPERVISING PHARMACIST OWNER
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    Name                 |     CHRISTOS  TRAKOSHIS 
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    Credential           |    
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    Telephone            |    718-278-6777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    3336C0003X
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    Taxonomy Name        |    Community/Retail 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        |    333600000X
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    Taxonomy Name        |    Pharmacy
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    License Number       |    026334
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    License Number State |    NY
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