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General NPI Number Information
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NPI Number | 1972651180
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Entity Type | Organization
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Legal Business Name | MEDCOURT PHARMACY, INC.
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 07/08/2013
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Provider Practice Location Address
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Address Line | 7701 37TH AVE
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6607
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Country | US
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Telephone | 718-651-0795
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Fax | 718-651-0054
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Provider Business Mailing Address
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Address Line | 7701 37TH AVE
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6607
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Country | US
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Telephone | 718-651-0795
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Fax | 718-651-0054
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN KRANJAC
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Credential | R.PH.
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Telephone | 718-651-0795
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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 | 017553
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License Number State | NY
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