MEDICARE: SAL PHARMACY CORP.

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	183500000X	Pharmacist	026358	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	026358	OTHER	NM	PHARMACY LICENSE
2	3335610	OTHER	NY	NCPDP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	R6Y	OTHER	NY	ETIN

General Provider Information

NPI Number	:	1811985476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAL PHARMACY CORP.

Provider Business Mailing Address
First Line	:	1665 RALPH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3317
Country	:	US
Telephone Number	:	718-209-3434
Fax Number	:	718-209-3279

Provider Business Practice Location Address
First Line	:	1665 RALPH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3317
Country	:	US
Telephone Number	:	718-209-3434
Fax Number	:	718-209-3279

Authorized Official
Title or Position	:	PHARMACIST/OWNER
Name	:	MRS. IRINA OSPOVAT
Credential	:	RPH
Telephone Number	:	718-209-3434

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	03/07/2023

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Directions to “SAL PHARMACY CORP. ” Practice Location

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