MEDICARE: RSVM DRUGS

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	34264	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	:	1417982398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RSVM DRUGS

Provider Business Mailing Address
First Line	:	4013 5TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11232-3446
Country	:	US
Telephone Number	:	718-436-8239
Fax Number	:	718-436-8240

Provider Business Practice Location Address
First Line	:	4013 5TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11232-3446
Country	:	US
Telephone Number	:	718-436-8239
Fax Number	:	718-436-8240

Authorized Official
Title or Position	:	PHARMACIST
Name	:	SAMMY RAM
Credential	:	RPH
Telephone Number	:	718-436-8239

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	08/22/2020

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Directions to “RSVM DRUGS ” Practice Location

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