MEDICARE: H&R NYC PHARMACEUTICAL 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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720885387
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H&R NYC PHARMACEUTICAL LLC

Provider Business Mailing Address
First Line	:	1265 CLOVE RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10301-4339
Country	:	US
Telephone Number	:	718-808-0018
Fax Number	:	917-397-9362

Provider Business Practice Location Address
First Line	:	1265 CLOVE RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10301-4339
Country	:	US
Telephone Number	:	718-808-0018
Fax Number	:	917-397-9362

Authorized Official
Title or Position	:	PHARMACIST
Name	:	LISA MARIE GEOLY
Credential	:	RPH
Telephone Number	:	718-808-0018

Provider Enumeration Date	:	02/28/2025
Last Update Date	:	02/28/2025

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Directions to “H&R NYC PHARMACEUTICAL LLC ” Practice Location

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