# CHURCH AVE PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CHURCH AVE PHARMACY INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700114790
- **Authorized official:** YEFIM BUBIS (SUPERVISOR PHARMACIST)
- **Authorized official phone:** (718) 941-2200

## Contact information

- **Practice address:** 1810 CHURCH AVE, BROOKLYN, NY 11226
- **Practice address phone:** (718) 941-2200
- **Practice address fax:** (718) 941-2300
- **Mailing address:** 1810 CHURCH AVE, BROOKLYN, NY 11226
- **Mailing address phone:** (718) 941-2200
- **Mailing address fax:** (718) 941-2300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 029857 | NY | Yes |

## Other

- **Enumeration date:** 12/02/2009
- **Last updated:** 06/02/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2123154 | PK | — |
| 05 | — | 3176450 | — | NY |