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NPI Code Detail

MEDICARE: BI-WISE PHARMACY CORP.

MEDICARE: BI-WISE PHARMACY CORP.
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
1333600000XPharmacy028266NY

Other Identifiers

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

General Provider Information

NPI Number : 1053472753
Entity Type Code : Organization
Provider Name (Legal Business Name) : BI-WISE PHARMACY CORP.
Provider Business Mailing Address
First Line : 26 WEST PARK AVE
Second Line :
City : LONG BEACH
State : NY
Zip : 11561-2018
Country : US
Telephone Number : 516-432-7131
Fax Number : 516-432-9347
Provider Business Practice Location Address
First Line : 26 WEST PARK AVE
Second Line :
City : LONG BEACH
State : NY
Zip : 11561-2018
Country : US
Telephone Number : 516-432-7131
Fax Number : 516-432-9347
Authorized Official
Title or Position : PRESIDENT
Name : MR. MITCHELL MATZA
Credential :
Telephone Number : 516-432-7131
Provider Enumeration Date : 12/13/2006
Last Update Date : 02/08/2008

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Directions to “BI-WISE PHARMACY CORP. ” Practice Location

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