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General NPI Number Information
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NPI Number | 1710352836
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Entity Type | Organization
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Legal Business Name | CHEMPLUS PHARMACY CORP
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Dates
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Enumeration Date | 12/01/2015
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Last Update Date | 04/17/2019
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Provider Practice Location Address
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Address Line | 1336 UTICA AVE
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City | BROOKLYN
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State | NY
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Zip | 11203-5912
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Country | US
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Telephone | 718-935-1033
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Fax | 718-935-1113
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Provider Business Mailing Address
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Address Line | 648 SCHROEDERS AVE
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City | BROOKLYN
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State | NY
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Zip | 11239-2234
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Country | US
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Telephone | 347-299-9515
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Fax | 718-935-1113
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST
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Name | DIANNA ELISHAIYEV
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Credential |
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Telephone | 718-935-1033
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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 | 034117
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License Number State | NY
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