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NPI Code Detail

MEDICARE: HEALTH MART PHARMACY INC

MEDICARE: HEALTH MART 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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy033509NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22151153OTHERPK

General Provider Information

NPI Number : 1376937961
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTH MART PHARMACY INC
Provider Business Mailing Address
First Line : 6924 4TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-1502
Country : US
Telephone Number : 347-599-1165
Fax Number : 718-433-3946
Provider Business Practice Location Address
First Line : 6924 4TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-1502
Country : US
Telephone Number : 347-599-1165
Fax Number : 718-433-3946
Authorized Official
Title or Position : OWNER/ PHARMACY MANAGER
Name : MALAAK AFANEH
Credential : PHARM D.
Telephone Number : 347-599-1165
Provider Enumeration Date : 03/23/2015
Last Update Date : 10/16/2021

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