MEDICARE: OK PHARMACY & SURGICAL

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	030361	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2126377	OTHER		PK

General Provider Information

NPI Number	:	1932414661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OK PHARMACY & SURGICAL

Provider Business Mailing Address
First Line	:	3404 UNION ST
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-3053
Country	:	US
Telephone Number	:	718-886-2227
Fax Number	:	718-886-2212

Provider Business Practice Location Address
First Line	:	3404 UNION ST
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-3053
Country	:	US
Telephone Number	:	718-886-2227
Fax Number	:	718-886-2212

Authorized Official
Title or Position	:	RPIC/PARTNER
Name	:	KEVIN SHI
Credential	:
Telephone Number	:	646-934-0803

Provider Enumeration Date	:	08/18/2010
Last Update Date	:	10/01/2013

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Directions to “OK PHARMACY & SURGICAL ” Practice Location

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