MEDICARE: BEDFORD 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	031001	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5804112	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1982976650
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEDFORD DRUGS, INC.

Provider Business Mailing Address
First Line	:	424 OLD POST RD
Second Line	:
City	:	BEDFORD
State	:	NY
Zip	:	10506-1018
Country	:	US
Telephone Number	:	914-234-3744
Fax Number	:	914-234-0652

Provider Business Practice Location Address
First Line	:	424 OLD POST RD
Second Line	:
City	:	BEDFORD
State	:	NY
Zip	:	10506-1018
Country	:	US
Telephone Number	:	914-234-3744
Fax Number	:	914-234-0652

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ABE RUTMAN
Credential	:
Telephone Number	:	914-234-3744

Provider Enumeration Date	:	01/27/2012
Last Update Date	:	05/03/2022

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