MEDICARE: LEFFERTS 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	024299	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2062028	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427137819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEFFERTS PHARMACY INC

Provider Business Mailing Address
First Line	:	5825 5TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3819
Country	:	US
Telephone Number	:	718-439-6360
Fax Number	:	718-492-1234

Provider Business Practice Location Address
First Line	:	5825 5TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3819
Country	:	US
Telephone Number	:	718-439-6360
Fax Number	:	718-492-1234

Authorized Official
Title or Position	:	SPH PRESIDENT
Name	:	MOHAMMAD AHAMD
Credential	:
Telephone Number	:	718-439-6360

Provider Enumeration Date	:	11/04/2006
Last Update Date	:	12/13/2016

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Directions to “LEFFERTS PHARMACY INC ” Practice Location

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