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General NPI Number Information
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NPI Number | 1407375389
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Entity Type | Organization
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Legal Business Name | DELTA PHARMACY INC.
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Dates
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Enumeration Date | 09/12/2017
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Last Update Date | 09/12/2017
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Provider Practice Location Address
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Address Line | 4202 CHURCH AVE
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City | BROOKLYN
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State | NY
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Zip | 11203-3012
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Country | US
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Telephone | 347-663-3944
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Fax | 347-663-3943
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Provider Business Mailing Address
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Address Line | 1270 BARRY DR S
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City | VALLEY STREAM
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State | NY
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Zip | 11580-1533
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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 | PHARMACIST
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Name | MR. HISBERT PRECIL
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Credential | RPH
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Telephone | 646-642-2035
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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 | I049966
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License Number State | NY
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