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General NPI Number Information
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NPI Number | 1447416284
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Entity Type | Organization
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Legal Business Name | HOMECARE CONCEPTS PHARMACY
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Dates
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Enumeration Date | 07/31/2008
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 226 MAIN ST SUITE A
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City | FARMINGDALE
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State | NY
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Zip | 11735-2618
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Country | US
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Telephone | 631-752-0555
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Fax | 631-752-8040
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Provider Business Mailing Address
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Address Line | 1095 ROUTE 110 SUITE A
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City | FARMINGDALE
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State | NY
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Zip | 11735-4815
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Country | US
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Telephone | 631-752-0555
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Fax | 631-752-8041
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. THOMAS RYAN
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Credential |
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Telephone | 631-752-0555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 025345
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License Number State | NY
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