MEDICARE: VALLEY STREAM 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	3336C0003X	Community/Retail Pharmacy	033976	NY

General Provider Information

NPI Number	:	1982078978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY STREAM PHARMACY INC

Provider Business Mailing Address
First Line	:	238 ROCKAWAY AVE STE A
Second Line	:
City	:	VALLEY STREAM
State	:	NY
Zip	:	11580-5843
Country	:	US
Telephone Number	:	516-442-0200
Fax Number	:	516-442-0306

Provider Business Practice Location Address
First Line	:	238 ROCKAWAY AVE STE A
Second Line	:
City	:	VALLEY STREAM
State	:	NY
Zip	:	11580-5843
Country	:	US
Telephone Number	:	516-442-0200
Fax Number	:	516-442-0306

Authorized Official
Title or Position	:	OWNER
Name	:	SYED AHMAR ALI
Credential	:
Telephone Number	:	516-442-0200

Provider Enumeration Date	:	11/14/2015
Last Update Date	:	03/19/2025

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