Provider Demographics
NPI:1083665632
Name:LEVRON, INC.
Entity Type:Organization
Organization Name:LEVRON, INC.
Other - Org Name:TITAN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEVIS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-267-8063
Mailing Address - Street 1:3519 31ST AVE
Mailing Address - Street 2:PO BOX 6246
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-1408
Mailing Address - Country:US
Mailing Address - Phone:718-267-0863
Mailing Address - Fax:718-267-8562
Practice Address - Street 1:3519 31ST AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-1408
Practice Address - Country:US
Practice Address - Phone:718-267-0863
Practice Address - Fax:718-267-8562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0248483336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3320277OtherNCDCP (NABP) NUMBER
NY02211723Medicaid
NY02211723Medicaid