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Organization
EVERS LTC INC
Active
Organization
EVERS LTC INC
Active
Other names
Evers LTC Inc
Organization subpart
No
Provider details
NPI number
Authorized official
HARALAMPOS RALLAKIS (PRESIDENT)
(718) 762-7400
Entity
Organization
Contact information
Practice address
3050 WHITESTONE EXPY STE 107, SUITE 107, FLUSHING, NY 11354-1995
(718) 762-7400
(718) 762-7404
Mailing address
3050 WHITESTONE EXPY, SUITE 107, FLUSHING, NY 11354-1964
(718) 762-7400
(718) 762-7404
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0004X
Compounding Pharmacy
—
NULL
3336H0001X
Home Infusion Therapy Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
031139
NY
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03444002
—
NY
01
—
5804605
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/28/2012
Last updated
09/19/2012
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