# ELM PHARMACY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Elm Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902897259
- **Authorized official:** MR. LEIB GERSHKOVICH R.PH. (PRESIDENT)
- **Authorized official phone:** (718) 336-8300

## Contact information

- **Practice address:** 1651 CONEY ISLAND AVE, BROOKLYN, NY 11230-5849
- **Practice address phone:** (718) 336-8300
- **Practice address fax:** (718) 336-8421
- **Mailing address:** 1651 CONEY ISLAND AVE, BROOKLYN, NY 11230-5849
- **Mailing address phone:** (718) 336-8300
- **Mailing address fax:** (718) 336-8421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 022262 | NY | Yes |

## Other

- **Enumeration date:** 11/03/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 01633985 | — | NY |
| 01 | — | 3369988 | NABP OR NCPDP | NY |
| 01 | — | A1298567 | OXFORD DME PROVIDER \# | NY |