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NPI Code Detail

MEDICARE: ALDAV PHARMACY, INC

MEDICARE: ALDAV 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
13336L0003XLong Term Care Pharmacy

General Provider Information

NPI Number : 1780523506
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALDAV PHARMACY, INC
Provider Business Mailing Address
First Line : 749 OCEAN PKWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-7813
Country : US
Telephone Number : 718-724-2245
Fax Number : 718-724-0975
Provider Business Practice Location Address
First Line : 749 OCEAN PKWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-7813
Country : US
Telephone Number : 718-724-2245
Fax Number : 718-724-0975
Authorized Official
Title or Position : SUPERVISING PHARMACIST
Name : RENA YANVARASHVILI
Credential :
Telephone Number : 718-724-2245
Provider Enumeration Date : 03/26/2026
Last Update Date : 03/26/2026

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