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General NPI Number Information
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NPI Number | 1619968039
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Entity Type | Organization
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Legal Business Name | MELBOURNE CHEMISTS INC.
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Dates
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Enumeration Date | 11/03/2005
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Last Update Date | 06/16/2015
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Provider Practice Location Address
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Address Line | 2021 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10453-4304
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Country | US
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Telephone | 718-299-2800
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Fax | 718-299-5113
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Provider Business Mailing Address
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Address Line | 2021 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10453-4304
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Country | US
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Telephone | 718-299-2800
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Fax | 718-299-5113
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Authorized Official
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Title or Position | VP
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Name | MR. SHELDON IRA MILLER
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Credential | RPH
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Telephone | 718-299-2800
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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 | 017412
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License Number State | NY
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