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NPI 1902897259

NPI 1902897259 : ELM PHARMACY, INC. : BROOKLYN, NY

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General NPI Number Information
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    NPI Number           |    1902897259
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    Entity Type          |    Organization 
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    Legal Business Name  |    ELM PHARMACY, INC. 
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Dates
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    Enumeration Date     |    11/03/2005
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    1651 CONEY ISLAND AVE 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11230-5849
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    Country              |    US
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    Telephone            |    718-336-8300
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    Fax                  |    718-336-8421
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Provider Business Mailing Address
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    Address Line         |    1651 CONEY ISLAND AVE 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11230-5849
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    Country              |    US
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    Telephone            |    718-336-8300
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    Fax                  |    718-336-8421
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    MR. LEIB  GERSHKOVICH 
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    Credential           |    R.PH.
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    Telephone            |    718-336-8300
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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       |    022262
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    License Number State |    NY
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