MEDICARE: NORWOOD 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	333600000X	Pharmacy	030308	NY

General Provider Information

NPI Number	:	1720397920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORWOOD PHARMACY LLC

Provider Business Mailing Address
First Line	:	2490 FREDERICK DOUGLASS BLVD
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10030-2792
Country	:	US
Telephone Number	:	212-234-6611
Fax Number	:	212-234-6992

Provider Business Practice Location Address
First Line	:	2490 FREDERICK DOUGLASS BLVD
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10030-2792
Country	:	US
Telephone Number	:	212-234-6611
Fax Number	:	212-234-6992

Authorized Official
Title or Position	:	MEMBER
Name	:	MR. RAJESH H PIPALIA
Credential	:
Telephone Number	:	212-234-6611

Provider Enumeration Date	:	10/05/2010
Last Update Date	:	10/16/2014

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