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NPI Code Detail

MEDICARE: PLANET PHARMACY LLC

MEDICARE: PLANET PHARMACY LLC
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
1333600000XPharmacy031673NY

General Provider Information

NPI Number : 1629319108
Entity Type Code : Organization
Provider Name (Legal Business Name) : PLANET PHARMACY LLC
Provider Business Mailing Address
First Line : 2336A GRAND CONCOURSE
Second Line :
City : BRONX
State : NY
Zip : 10458
Country : US
Telephone Number : 718-220-2035
Fax Number : 718-220-2826
Provider Business Practice Location Address
First Line : 2336 GRAND CONCOURSE
Second Line :
City : BRONX
State : NY
Zip : 10458-6903
Country : US
Telephone Number : 718-220-2035
Fax Number : 718-220-2826
Authorized Official
Title or Position : PRESIDENT
Name : MR. IGOR GRABOV
Credential :
Telephone Number : 718-220-2035
Provider Enumeration Date : 03/08/2013
Last Update Date : 04/08/2014

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Directions to “PLANET PHARMACY LLC ” Practice Location

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