MEDICARE: LOVING 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	029763	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3363075	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1316274582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVING PHARMACY INC

Provider Business Mailing Address
First Line	:	5711 6TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3807
Country	:	US
Telephone Number	:	718-680-1982
Fax Number	:	718-680-1962

Provider Business Practice Location Address
First Line	:	5711 6TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3807
Country	:	US
Telephone Number	:	718-680-1982
Fax Number	:	718-680-1962

Authorized Official
Title or Position	:	SUPERVISING PHARMACIST
Name	:	CHUN MING LIN
Credential	:
Telephone Number	:	718-680-1982

Provider Enumeration Date	:	11/10/2009
Last Update Date	:	11/10/2009

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Directions to “LOVING PHARMACY INC ” Practice Location

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