MEDICARE: 668 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

General Provider Information

NPI Number	:	1972242741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	668 PHARMACY INC

Provider Business Mailing Address
First Line	:	2439 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4459
Country	:	US
Telephone Number	:	718-912-6888
Fax Number	:	929-383-6123

Provider Business Practice Location Address
First Line	:	2439 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4459
Country	:	US
Telephone Number	:	718-912-6888
Fax Number	:	929-383-6123

Authorized Official
Title or Position	:	SP
Name	:	WAI HONG HO
Credential	:	RPH
Telephone Number	:	646-361-7087

Provider Enumeration Date	:	05/31/2022
Last Update Date	:	05/31/2022

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