MEDICARE: 110 METRO DRUGS, 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	:	1982130043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	110 METRO DRUGS, INC.

Provider Business Mailing Address
First Line	:	2061 ATLANTIC AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11233-3202
Country	:	US
Telephone Number	:	516-528-3120
Fax Number	:

Provider Business Practice Location Address
First Line	:	2061 ATLANTIC AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11233-3202
Country	:	US
Telephone Number	:	516-528-3120
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MOHAMMAD ALI
Credential	:
Telephone Number	:	516-528-3120

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	05/11/2017

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