MEDICARE: WOODROW 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
2	3336C0003X	Community/Retail Pharmacy	021500	NY

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
2	3327245	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1730178526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODROW PHARMACY LTD

Provider Business Mailing Address
First Line	:	645 ROSSVILLE AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10309-1752
Country	:	US
Telephone Number	:	718-967-2955
Fax Number	:	718-967-2978

Provider Business Practice Location Address
First Line	:	645 ROSSVILLE AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10309-1752
Country	:	US
Telephone Number	:	718-967-2955
Fax Number	:	718-967-2978

Authorized Official
Title or Position	:	PRESIDENT AND OWNER
Name	:	ALLEN HEIT
Credential	:
Telephone Number	:	718-967-2955

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	04/19/2011

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Directions to “WOODROW PHARMACY LTD ” Practice Location

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