MEDICARE: YOUR HEALTH 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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	025832	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2059432	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932207966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUR HEALTH PHARMACY INC

Provider Business Mailing Address
First Line	:	80 E 116TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-1128
Country	:	US
Telephone Number	:	212-348-7788
Fax Number	:	212-348-4944

Provider Business Practice Location Address
First Line	:	80 E 116TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-1128
Country	:	US
Telephone Number	:	212-348-7788
Fax Number	:	212-348-4944

Authorized Official
Title or Position	:	REGISTERED PHARMACIST
Name	:	JOHN SUNDERRAJ
Credential	:
Telephone Number	:	212-348-7788

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	02/02/2015

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Directions to “YOUR HEALTH PHARMACY INC ” Practice Location

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