MEDICARE: AHMALL DRUG CORP

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	018524	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	7383140001	OTHER	NY	MEDICARE

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

General Provider Information

NPI Number	:	1336539154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AHMALL DRUG CORP

Provider Business Mailing Address
First Line	:	750 FLATBUSH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-1902
Country	:	US
Telephone Number	:	718-856-5995
Fax Number	:	718-856-5029

Provider Business Practice Location Address
First Line	:	750 FLATBUSH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-1902
Country	:	US
Telephone Number	:	718-856-5995
Fax Number	:	718-856-5029

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANISUL HASAN
Credential	:	RPH
Telephone Number	:	917-873-4360

Provider Enumeration Date	:	02/01/2015
Last Update Date	:	02/12/2024

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Directions to “AHMALL DRUG CORP ” Practice Location

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