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NPI Code Detail

MEDICARE: DUANE READE

MEDICARE: DUANE READE
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
13336C0003XCommunity/Retail Pharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
3333600000XPharmacy023571NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23335848OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1194741215
Entity Type Code : Organization
Provider Name (Legal Business Name) : DUANE READE
Provider Business Mailing Address
First Line : 1901 E VOORHEES ST
Second Line : MS 790
City : DANVILLE
State : IL
Zip : 61834-4515
Country : US
Telephone Number : 847-527-2489
Fax Number : 217-709-2344
Provider Business Practice Location Address
First Line : 4702 5TH ST
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101-5411
Country : US
Telephone Number : 718-472-3600
Fax Number : 718-361-5893
Authorized Official
Title or Position : MANAGER
Name : JENNIFER PONCE
Credential :
Telephone Number : 847-527-2489
Provider Enumeration Date : 07/14/2006
Last Update Date : 10/22/2025

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Directions to “DUANE READE ” Practice Location

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