MEDICARE: ALLERTON CORP

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	028470	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	:	1497946669
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLERTON CORP

Provider Business Mailing Address
First Line	:	1320 METROPOLITAN AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-7971
Country	:	US
Telephone Number	:	718-466-5500
Fax Number	:	718-466-5505

Provider Business Practice Location Address
First Line	:	1320 METROPOLITAN AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-7971
Country	:	US
Telephone Number	:	718-466-5500
Fax Number	:	718-466-5505

Authorized Official
Title or Position	:	SUPERVISING PHARMACIST
Name	:	HMZA MENWER
Credential	:
Telephone Number	:	718-466-5500

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	11/23/2021

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Directions to “ALLERTON CORP ” Practice Location

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