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NPI Code Detail

MEDICARE: PHILLIPS PHARMACY INC

MEDICARE: PHILLIPS 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
13336L0003XLong Term Care Pharmacy

General Provider Information

NPI Number : 1326795014
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHILLIPS PHARMACY INC
Provider Business Mailing Address
First Line : 3921 9TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11232-3207
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3921 9TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11232-3207
Country : US
Telephone Number : 718-435-7790
Fax Number :
Authorized Official
Title or Position : VP
Name : DAVID GREENFIELD
Credential :
Telephone Number : 718-435-7790
Provider Enumeration Date : 03/03/2022
Last Update Date : 03/28/2022

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