MEDICARE: TOP VALUE 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
1	3336L0003X	Long Term Care Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	031898	OTHER	NY	STATE PHARMACY LICENSE

General Provider Information

NPI Number	:	1639977473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOP VALUE PHARMACY LLC

Provider Business Mailing Address
First Line	:	3811 DYRE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-6112
Country	:	US
Telephone Number	:	718-325-1355
Fax Number	:

Provider Business Practice Location Address
First Line	:	3811 DYRE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-6112
Country	:	US
Telephone Number	:	718-325-1355
Fax Number	:

Authorized Official
Title or Position	:	MEMBER OWNER
Name	:	PANKIT SUTARIA
Credential	:
Telephone Number	:	718-325-1355

Provider Enumeration Date	:	03/06/2025
Last Update Date	:	03/10/2025

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