MEDICARE: RAVENVIEW 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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1740075373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAVENVIEW PHARMACY INC

Provider Business Mailing Address
First Line	:	3449 21ST ST
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-4721
Country	:	US
Telephone Number	:	718-729-5199
Fax Number	:

Provider Business Practice Location Address
First Line	:	3449 21ST ST
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-4721
Country	:	US
Telephone Number	:	718-729-5199
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. N/A N/A N/A
Credential	:
Telephone Number	:	718-729-5199

Provider Enumeration Date	:	04/14/2025
Last Update Date	:	05/28/2025

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Directions to “RAVENVIEW PHARMACY INC ” Practice Location

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