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NPI Code Detail

MEDICARE: DR. ROY CARROLL LILLY JR. PHARM.D., R.PH.

MEDICARE: DR. ROY CARROLL LILLY JR. PHARM.D., R.PH.
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
1183500000XPharmacist8705AR
2183500000XPharmacist13083NC
31835P2201XAmbulatory Care PharmacistI052236NY

General Provider Information

NPI Number : 1972596559
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROY CARROLL LILLY JR. PHARM.D., R.PH.
Provider Business Mailing Address
First Line : 265 ASHLAND PL
Second Line :
City : BROOKLYN
State : NY
Zip : 11217-1661
Country : US
Telephone Number : 718-858-7200
Fax Number : 718-246-9357
Provider Business Practice Location Address
First Line : 265 ASHLAND PL
Second Line :
City : BROOKLYN
State : NY
Zip : 11217-1661
Country : US
Telephone Number : 718-858-7200
Fax Number : 718-246-9357
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2005
Last Update Date : 12/10/2025

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