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NPI Code Detail

MEDICARE: ADLIB PHARMACY CORP

MEDICARE: ADLIB PHARMACY 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
13336C0004XCompounding Pharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
3333600000XPharmacy
43336C0003XCommunity/Retail Pharmacy027996NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23328855OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1356341689
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADLIB PHARMACY CORP
Provider Business Mailing Address
First Line : 21519 73RD AVE
Second Line :
City : OAKLAND GARDENS
State : NY
Zip : 11364-2928
Country : US
Telephone Number : 718-428-8200
Fax Number : 718-428-7783
Provider Business Practice Location Address
First Line : 21519 73RD AVE
Second Line :
City : OAKLAND GARDENS
State : NY
Zip : 11364-2928
Country : US
Telephone Number : 718-428-8200
Fax Number : 718-428-7783
Authorized Official
Title or Position : SUPERVISING PHCIST
Name : CHAIM KURZ
Credential : RPH
Telephone Number : 718-428-8200
Provider Enumeration Date : 07/28/2005
Last Update Date : 10/11/2010

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