MEDICARE: MERCY 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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	031795	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2139709	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356683296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY PHARMACY INC

Provider Business Mailing Address
First Line	:	6413 18TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-3730
Country	:	US
Telephone Number	:	718-256-1020
Fax Number	:	718-256-1030

Provider Business Practice Location Address
First Line	:	6413 18TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-3730
Country	:	US
Telephone Number	:	718-256-1020
Fax Number	:	718-256-1030

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KIT YEE NGAI
Credential	:
Telephone Number	:	718-256-1020

Provider Enumeration Date	:	03/18/2013
Last Update Date	:	05/01/2017

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Directions to “MERCY PHARMACY INC ” Practice Location

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