MEDICARE: 181 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	3336C0003X	Community/Retail Pharmacy	025953	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
2	3331941	OTHER	NY	NCPDP

General Provider Information

NPI Number	:	1437162781
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	181 PHARMACY INC.

Provider Business Mailing Address
First Line	:	565 W 181ST ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-5004
Country	:	US
Telephone Number	:	212-543-2616
Fax Number	:	212-543-2632

Provider Business Practice Location Address
First Line	:	565 W 181ST ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-5004
Country	:	US
Telephone Number	:	212-543-2616
Fax Number	:	212-543-2632

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ARCHANA PATEL
Credential	:
Telephone Number	:	212-543-2616

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	02/06/2008

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