MEDICARE: S & K WARBASSE 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	028471	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	:	1790825958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S & K WARBASSE PHARMACY, INC

Provider Business Mailing Address
First Line	:	499 NEPTUNE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-4003
Country	:	US
Telephone Number	:	718-449-5177
Fax Number	:	718-449-1004

Provider Business Practice Location Address
First Line	:	499 NEPTUNE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-4003
Country	:	US
Telephone Number	:	718-449-5177
Fax Number	:	718-449-1004

Authorized Official
Title or Position	:	PHARMACIST
Name	:	MR. SIMON FIELD
Credential	:
Telephone Number	:	718-449-5177

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	02/28/2008

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