MEDICARE: MYRTLE DRUG CARE 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	:	1922344795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MYRTLE DRUG CARE CORP

Provider Business Mailing Address
First Line	:	1959 WESTCHESTER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10462-4505
Country	:	US
Telephone Number	:	718-824-3745
Fax Number	:	718-824-3746

Provider Business Practice Location Address
First Line	:	355 MYRTLE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11205-3216
Country	:	US
Telephone Number	:	718-855-2292
Fax Number	:	718-855-2297

Authorized Official
Title or Position	:	OFFICER
Name	:	MR. MAHMOUD TEHFE
Credential	:
Telephone Number	:	347-607-4014

Provider Enumeration Date	:	12/21/2012
Last Update Date	:	12/21/2012

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Directions to “MYRTLE DRUG CARE CORP ” Practice Location

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