MEDICARE: AMITH & ADITH 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	029683	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3362477	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1629204367
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMITH & ADITH PHARMACY INC

Provider Business Mailing Address
First Line	:	32 LINDEN BLVD
Second Line	:
City	:	HICKSVILLE
State	:	NY
Zip	:	11801-5936
Country	:	US
Telephone Number	:	718-623-8930
Fax Number	:	718-623-8914

Provider Business Practice Location Address
First Line	:	378 LAFAYETTE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11238-1472
Country	:	US
Telephone Number	:	718-623-8930
Fax Number	:	718-623-8914

Authorized Official
Title or Position	:	OWNER/SUPERVISING PHARMACIST
Name	:	ANUGU REDDY
Credential	:
Telephone Number	:	718-623-8930

Provider Enumeration Date	:	06/09/2009
Last Update Date	:	04/07/2011

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Directions to “AMITH & ADITH PHARMACY INC ” Practice Location

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