Provider Demographics
NPI:1295390474
Name:ONE SPOT PHARMACY LLC
Entity Type:Organization
Organization Name:ONE SPOT PHARMACY LLC
Other - Org Name:ONE SPOT PHARMACY LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-889-7050
Mailing Address - Street 1:8204 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-2901
Mailing Address - Country:US
Mailing Address - Phone:347-889-7050
Mailing Address - Fax:347-889-7053
Practice Address - Street 1:8204 18TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-2901
Practice Address - Country:US
Practice Address - Phone:347-889-7050
Practice Address - Fax:347-889-7053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-03
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy