MEDICARE: 18 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	034670	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	2160929	OTHER		PK

General Provider Information

NPI Number	:	1568812451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	18 PHARMACY INC

Provider Business Mailing Address
First Line	:	89 BOWERY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10002-4915
Country	:	US
Telephone Number	:	212-571-0027
Fax Number	:	212-571-0022

Provider Business Practice Location Address
First Line	:	89 BOWERY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10002-4915
Country	:	US
Telephone Number	:	212-571-0027
Fax Number	:	212-571-0022

Authorized Official
Title or Position	:	OWNER
Name	:	ELTON CHOW
Credential	:
Telephone Number	:	212-571-0027

Provider Enumeration Date	:	06/21/2016
Last Update Date	:	05/06/2022

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