MEDICARE: MEGA AID 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	028473	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	:	1487847471
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEGA AID PHARMACY INC.

Provider Business Mailing Address
First Line	:	3112 MERMAID AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-1808
Country	:	US
Telephone Number	:	718-333-9133
Fax Number	:	718-333-1133

Provider Business Practice Location Address
First Line	:	3112 MERMAID AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-1808
Country	:	US
Telephone Number	:	718-333-9133
Fax Number	:	718-333-1133

Authorized Official
Title or Position	:	SUPERVISING PHARMACIST
Name	:	MAYA BASIN
Credential	:	RPH.
Telephone Number	:	718-333-9133

Provider Enumeration Date	:	08/22/2007
Last Update Date	:	05/30/2008

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