MEDICARE: JOST PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy
2	333600000X	Pharmacy	020118	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033106992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOST PHARMACY INC

Provider Business Mailing Address
First Line	:	3601 QUENTIN RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4203
Country	:	US
Telephone Number	:	718-339-3110
Fax Number	:	718-339-5260

Provider Business Practice Location Address
First Line	:	3601 QUENTIN RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4203
Country	:	US
Telephone Number	:	718-339-3110
Fax Number	:	718-339-5260

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. RADA LEVKOVSKAYA
Credential	:
Telephone Number	:	718-339-3110

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	02/02/2023

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Directions to “JOST PHARMACY INC ” Practice Location

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