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General NPI Number Information
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NPI Number | 1487928164
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Entity Type | Organization
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Legal Business Name | EVERS LTC INC
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Dates
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Enumeration Date | 02/28/2012
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Last Update Date | 09/19/2012
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Provider Practice Location Address
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Address Line | 3050 WHITESTONE EXPY STE 107 SUITE 107
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City | FLUSHING
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State | NY
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Zip | 11354-1995
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Country | US
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Telephone | 718-762-7400
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Fax | 718-762-7404
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Provider Business Mailing Address
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Address Line | 3050 WHITESTONE EXPY SUITE 107
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City | FLUSHING
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State | NY
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Zip | 11354-1964
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Country | US
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Telephone | 718-762-7400
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Fax | 718-762-7404
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Authorized Official
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Title or Position | PRESIDENT
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Name | HARALAMPOS RALLAKIS
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Credential |
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Telephone | 718-762-7400
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 031139
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License Number State | NY
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