MEDICARE: BRAUNAGEL & BRAUNAGEL, 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0004X	Compounding Pharmacy
4	3336L0003X	Long Term Care Pharmacy
5	3336C0003X	Community/Retail Pharmacy	021257	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3322043	OTHER	NCPDP PROVIDER IDENTIFICATION NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386644987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAUNAGEL & BRAUNAGEL, INC.

Provider Business Mailing Address
First Line	:	12 SUSSEX ST
Second Line	:
City	:	PORT JERVIS
State	:	NY
Zip	:	12771-2421
Country	:	US
Telephone Number	:	845-856-8314
Fax Number	:	845-856-8315

Provider Business Practice Location Address
First Line	:	12 SUSSEX ST
Second Line	:
City	:	PORT JERVIS
State	:	NY
Zip	:	12771-2421
Country	:	US
Telephone Number	:	845-856-8314
Fax Number	:	845-856-3875

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CARL BRAUNAGEL
Credential	:	MBA
Telephone Number	:	845-856-8314

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	01/27/2025

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