MEDICARE: MEDS ON TIME 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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1831950112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDS ON TIME PHARMACY CORP.

Provider Business Mailing Address
First Line	:	3147 LAWSON BLVD
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-3717
Country	:	US
Telephone Number	:	516-208-7332
Fax Number	:	516-208-7333

Provider Business Practice Location Address
First Line	:	3147 LAWSON BLVD
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-3717
Country	:	US
Telephone Number	:	516-208-7332
Fax Number	:	516-208-7333

Authorized Official
Title or Position	:	OWNER
Name	:	MOISEY NEKTALOV
Credential	:	PHARM D
Telephone Number	:	347-712-7404

Provider Enumeration Date	:	01/23/2024
Last Update Date	:	01/23/2024

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