MEDICARE: AVE Z PHARMACY

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	3336C0004X	Compounding Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336M0003X	Managed Care Organization Pharmacy
4	333600000X	Pharmacy
5	3336C0003X	Community/Retail Pharmacy	030808	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
2	2132012	OTHER		PK

General Provider Information

NPI Number	:	1295028991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVE Z PHARMACY

Provider Business Mailing Address
First Line	:	1324 SHEEPSHEAD BAY RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3920
Country	:	US
Telephone Number	:	718-332-7733
Fax Number	:	718-332-2971

Provider Business Practice Location Address
First Line	:	1324 SHEEPSHEAD BAY RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3920
Country	:	US
Telephone Number	:	718-332-7733
Fax Number	:	718-332-2971

Authorized Official
Title or Position	:	PHARMACIST
Name	:	INEL LEVIYEVA
Credential	:
Telephone Number	:	718-332-7733

Provider Enumeration Date	:	05/27/2011
Last Update Date	:	11/10/2016

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Directions to “AVE Z PHARMACY ” Practice Location

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