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Contact Information

63 LEE AVE PHARMACY INC
63 LEE AVE
BROOKLYN, NY11211-7213
 Phone: 718-387-2852
 Fax: 718-388-4376
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for 63 LEE AVE PHARMACY INC

NPI Number 1710002878
LBN Legal business name 63 LEE AVE PHARMACY INC
Authorized official STUART SLATER - (PRES SPH)
Entity Organization
Organization subpart 1 No
Enumeration date 03/20/2007
Last updated 03/08/2011 - About 15 years ago
Identifiers
NY License # 013502
NY Medicaid 00268644
NY Other 3326902 NABP
NY Other 3326902 NCPDP NUMBER
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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