MEDICARE: EVE AND R 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	333600000X	Pharmacy	024452	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	:	1588652796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVE AND R PHARMACY INC.

Provider Business Mailing Address
First Line	:	170 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3740
Country	:	US
Telephone Number	:	718-946-0101
Fax Number	:	718-946-7588

Provider Business Practice Location Address
First Line	:	170 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3740
Country	:	US
Telephone Number	:	718-946-0101
Fax Number	:	718-946-7588

Authorized Official
Title or Position	:	V.PRES
Name	:	MR. DAVYD ESTRIN
Credential	:
Telephone Number	:	718-946-0101

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	02/26/2009

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