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Contact Information

115 IRVING AVE PHARMACY INC
1706B ATLANTIC AVE
BROOKLYN, NY11213-1206
 Phone: 718-484-2260
 Fax: 718-484-2261
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for 115 IRVING AVE PHARMACY INC

NPI # 1932265642
LBN Legal business name 115 IRVING AVE PHARMACY INC
Authorized official DEVANG RAVAL - (PHARMACY MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/28/2006
Last updated 04/24/2017 - About 9 years ago
Identifiers
NY License # 035113
NY Medicaid 00833192
Other 2062245 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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