Organization
PHARMACY DEPOT LLC
Active
Other names
pharmacy depot llc
Organization subpart
No
Provider details
NPI number
Authorized official
DINA SHIFGERT (SUPERVISING PHARMACIST)
(718) 646-0001
Entity
Organization
Contact information
Practice address
317 BRIGHTON BEACH AVE, BROOKLYN, NY 11235-7412
(718) 646-0001
Mailing address
317 BRIGHTON BEACH AVE, BROOKLYN, NY 11235-7412
(718) 646-0001
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
030569
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5802334
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/11/2011
Last updated
07/01/2019
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