Organization
PURECARE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TREVOR DEAN STARK (OWNER)
(718) 484-9803
Entity
Organization
Contact information
Practice address
1380 CONEY ISLAND AVE, BROOKLYN, NY 11230-4120
(718) 484-9803
(718) 484-9804
Mailing address
1380 CONEY ISLAND AVE, BROOKLYN, NY 11230-4120
(718) 484-9803
(718) 484-9804
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039887
STATE BOARD
NY
Enumeration date
11/29/2022
Last updated
01/15/2025
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