MEDICARE: FOUR K CHEMISTS LLC

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

General Provider Information

NPI Number	:	1437530367
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUR K CHEMISTS LLC

Provider Business Mailing Address
First Line	:	3859 BROADWAY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-1540
Country	:	US
Telephone Number	:	212-928-7700
Fax Number	:	917-398-1308

Provider Business Practice Location Address
First Line	:	3859 BROADWAY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-1540
Country	:	US
Telephone Number	:	212-928-7700
Fax Number	:	917-398-1308

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MAZEN S KARNABY
Credential	:	RPH
Telephone Number	:	917-836-8886

Provider Enumeration Date	:	06/16/2015
Last Update Date	:	06/16/2015

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Directions to “FOUR K CHEMISTS LLC ” Practice Location

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