MEDICARE: UMAMAH PITKIN 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

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	:	1679618060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UMAMAH PITKIN PHARMACY INC

Provider Business Mailing Address
First Line	:	2231 PITKIN AVENUE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11207
Country	:	US
Telephone Number	:	718-485-3724
Fax Number	:	718-495-3290

Provider Business Practice Location Address
First Line	:	2231 PITKIN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11207
Country	:	US
Telephone Number	:	718-485-3724
Fax Number	:	718-495-3290

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SARA MANSOUR
Credential	:
Telephone Number	:	718-384-5917

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	10/10/2024

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