MEDICARE: SHRINE 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

General Provider Information

NPI Number	:	1821724055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHRINE PHARMACY INC

Provider Business Mailing Address
First Line	:	13124 ROCKAWAY BLVD
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11420-2932
Country	:	US
Telephone Number	:	718-322-3261
Fax Number	:	718-322-3261

Provider Business Practice Location Address
First Line	:	13124 ROCKAWAY BLVD
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11420-2932
Country	:	US
Telephone Number	:	718-413-8830
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. PREETHA VARGHESE
Credential	:
Telephone Number	:	718-413-8830

Provider Enumeration Date	:	07/29/2022
Last Update Date	:	11/23/2022

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Directions to “SHRINE PHARMACY INC ” Practice Location

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