MEDICARE: JIM & PHIL'S FAMILY PHARMACY LTD.

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	16426	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3366615	OTHER		NCPDP ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	16426	OTHER	NY	PHARMACY LICENSE

General Provider Information

NPI Number	:	1689678138
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JIM & PHIL'S FAMILY PHARMACY LTD.

Provider Business Mailing Address
First Line	:	6109 5TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-4609
Country	:	US
Telephone Number	:	718-492-0900
Fax Number	:

Provider Business Practice Location Address
First Line	:	6109 5TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-4609
Country	:	US
Telephone Number	:	718-492-0900
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED PHARRMACIST, & CEO
Name	:	MRS. JAMES R. SCHIFFER
Credential	:	R.PH. J.D.
Telephone Number	:	718-492-0900

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	03/07/2023

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