Provider Demographics
NPI:1225226103
Name:S & K WARBASSE PHARMACY INC.
Entity Type:Organization
Organization Name:S & K WARBASSE PHARMACY INC.
Other - Org Name:S & K WARBASSE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-449-5177
Mailing Address - Street 1:499 NEPTUNE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-4003
Mailing Address - Country:US
Mailing Address - Phone:718-449-5177
Mailing Address - Fax:718-449-1004
Practice Address - Street 1:499 NEPTUNE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-4003
Practice Address - Country:US
Practice Address - Phone:718-449-5177
Practice Address - Fax:718-449-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0284713336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02873852Medicaid