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NPI Code Detail

MEDICARE: SILVER STAR PHARMACY INC

MEDICARE: SILVER STAR 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
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336C0003XCommunity/Retail Pharmacy032925NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22148240OTHERPK

General Provider Information

NPI Number : 1134521487
Entity Type Code : Organization
Provider Name (Legal Business Name) : SILVER STAR PHARMACY INC
Provider Business Mailing Address
First Line : 531 E 7TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11218-4801
Country : US
Telephone Number : 718-921-8777
Fax Number : 718-921-9777
Provider Business Practice Location Address
First Line : 531 E 7TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11218-4801
Country : US
Telephone Number : 718-921-8777
Fax Number : 718-921-9777
Authorized Official
Title or Position : PRESIDENT
Name : MIKE KOSTYLEV
Credential :
Telephone Number : 718-921-8777
Provider Enumeration Date : 09/18/2014
Last Update Date : 09/13/2016

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Directions to “SILVER STAR PHARMACY INC ” Practice Location

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