MEDICARE: SAVALL DRUG CO 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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	003271	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	2057527	OTHER		PK

General Provider Information

NPI Number	:	1811908460
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAVALL DRUG CO INC

Provider Business Mailing Address
First Line	:	393 MERRICK AVE
Second Line	:
City	:	N MERRICK
State	:	NY
Zip	:	11566-2723
Country	:	US
Telephone Number	:	516-379-3722
Fax Number	:	516-379-1755

Provider Business Practice Location Address
First Line	:	393 MERRICK AVE
Second Line	:
City	:	N MERRICK
State	:	NY
Zip	:	11566-2723
Country	:	US
Telephone Number	:	516-379-3722
Fax Number	:	516-379-1755

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	ROBERT KLIEGER
Credential	:
Telephone Number	:	516-379-3722

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	12/21/2016

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Directions to “SAVALL DRUG CO INC ” Practice Location

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