Organization
KINGS BAY PHARMACY
Active
Other names
SUPER VALUE DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY BESLKIN (PRESIDENT)
(718) 998-6200
Entity
Organization
Contact information
Practice address
2927 AVENUE S, BROOKLYN, NY 11229-3231
(718) 998-6200
(718) 998-6840
Mailing address
2927 AVENUE S, BROOKLYN, NY 11229-3231
(718) 998-6200
(718) 998-6840
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
024707
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02060066
—
NY
01
—
3314058
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/18/2006
Last updated
04/22/2011
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