MEDICARE: ARLO DRUG STORE OF LONG ISLAND 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	183500000X	Pharmacist	038503	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

General Provider Information

NPI Number	:	1356471023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARLO DRUG STORE OF LONG ISLAND INC

Provider Business Mailing Address
First Line	:	1022 PARK BLVD
Second Line	:
City	:	MASSAPEQUA PARK
State	:	NY
Zip	:	11762-2711
Country	:	US
Telephone Number	:	516-798-9444
Fax Number	:	516-798-0589

Provider Business Practice Location Address
First Line	:	1022 PARK BLVD
Second Line	:
City	:	MASSAPEQUA PARK
State	:	NY
Zip	:	11762-2711
Country	:	US
Telephone Number	:	516-798-9444
Fax Number	:	516-798-0589

Authorized Official
Title or Position	:	PHARMACIST
Name	:	TODD SVEC
Credential	:	RPH
Telephone Number	:	516-798-9444

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	08/22/2020

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