Provider Demographics
NPI:1295180883
Name:NEW BRITAIN PHARMACY INC.
Entity Type:Organization
Organization Name:NEW BRITAIN PHARMACY INC.
Other - Org Name:MARTYS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-525-8859
Mailing Address - Street 1:9422 AVENUE L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4809
Mailing Address - Country:US
Mailing Address - Phone:718-251-1313
Mailing Address - Fax:718-251-7792
Practice Address - Street 1:9422 AVENUE L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4809
Practice Address - Country:US
Practice Address - Phone:718-251-1313
Practice Address - Fax:718-251-7792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0346913336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2160728OtherPK
NY04628319Medicaid