MEDICARE: MEDASSURE LLC

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	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1922742949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDASSURE LLC

Provider Business Mailing Address
First Line	:	2334 WASHINGTON AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10458-7714
Country	:	US
Telephone Number	:	518-618-2220
Fax Number	:

Provider Business Practice Location Address
First Line	:	2334 WASHINGTON AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10458-7714
Country	:	US
Telephone Number	:	518-618-2220
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	IDAN LEVI
Credential	:
Telephone Number	:	518-618-2220

Provider Enumeration Date	:	04/26/2022
Last Update Date	:	04/26/2022

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Directions to “MEDASSURE LLC ” Practice Location

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