Organization
NATIONAL SPECIALITY PHARMACY LLC
Active
Other names
Pen Mill Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NINO CARNOVALE (OWNER)
(516) 791-6700
Entity
Organization
Contact information
Practice address
1336 PENINSULA BLVD, HEWLETT, NY 11557-1226
(516) 791-6700
(516) 791-8324
Mailing address
1336 PENINSULA BLVD, HEWLETT, NY 11557-1226
(516) 791-6700
(516) 791-8324
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
029156
NY
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03047174
—
NY
01
—
3360726
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/21/2008
Last updated
01/17/2012
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