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NPI Code Detail

MEDICARE: BASIN MIXTURES INC

MEDICARE: BASIN MIXTURES 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
13336C0003XCommunity/Retail Pharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
3333600000XPharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1037489OTHERNYPHARMACY REGISTRATION

General Provider Information

NPI Number : 1386297141
Entity Type Code : Organization
Provider Name (Legal Business Name) : BASIN MIXTURES INC
Provider Business Mailing Address
First Line : 6309 MILL LN
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-5512
Country : US
Telephone Number : 718-444-4749
Fax Number : 718-444-4376
Provider Business Practice Location Address
First Line : 6309 MILL LN
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-5512
Country : US
Telephone Number : 718-444-4749
Fax Number : 718-444-4376
Authorized Official
Title or Position : OWNER
Name : HASSAN MUYIR
Credential :
Telephone Number : 718-444-4749
Provider Enumeration Date : 07/22/2019
Last Update Date : 07/22/2019

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Directions to “BASIN MIXTURES INC ” Practice Location

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