Organization
HAVEMEYER PHARMACY INC
Active
Other names
Southside Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BASSANELL (PHARMACIST)
(646) 234-4181
Entity
Organization
Contact information
Practice address
259 S 2ND ST, BROOKLYN, NY 11211-8699
(718) 599-5991
(718) 599-5992
Mailing address
269 S 2ND ST, BROOKLYN, NY 11211-5449
(718) 599-5991
(718) 599-5992
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
031088
NY
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2134354
PK
—
Enumeration date
03/07/2012
Last updated
01/18/2024
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