MEDICARE: LESELL DRUGS 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	017876	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

General Provider Information

NPI Number	:	1760533434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LESELL DRUGS INC.

Provider Business Mailing Address
First Line	:	3161 BAINBRIDGE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-3907
Country	:	US
Telephone Number	:	718-547-8888
Fax Number	:	718-405-1877

Provider Business Practice Location Address
First Line	:	3161 BAINBRIDGE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-3907
Country	:	US
Telephone Number	:	718-547-8888
Fax Number	:	718-405-1877

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. LEONARD ZIMMERMAN
Credential	:	R.PH
Telephone Number	:	718-547-8888

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	02/06/2008

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Directions to “LESELL DRUGS INC. ” Practice Location

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