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General NPI Number Information
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NPI Number | 1821214396
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Entity Type | Organization
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Legal Business Name | 699 MERRICK INC
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 699 MERRICK RD
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City | LYNBROOK
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State | NY
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Zip | 11563-2324
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Country | US
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Telephone | 516-599-5959
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Fax | 516-599-2190
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Provider Business Mailing Address
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Address Line | 699 MERRICK RD
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City | LYNBROOK
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State | NY
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Zip | 11563-2324
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Country | US
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Telephone | 516-599-5959
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Fax | 516-599-2190
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. CHRISTOPHER MICHAEL REITER
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Credential | RPH
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Telephone | 516-599-5959
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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 | 028287
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License Number State | NY
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