Provider Demographics
NPI:1326390154
Name:WHITMAN PHARMACY LLC
Entity Type:Organization
Organization Name:WHITMAN PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:347-223-4563
Mailing Address - Street 1:329A MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-3201
Mailing Address - Country:US
Mailing Address - Phone:347-223-4563
Mailing Address - Fax:718-744-5308
Practice Address - Street 1:329A MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-3201
Practice Address - Country:US
Practice Address - Phone:917-815-0802
Practice Address - Fax:212-228-9668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-03
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03629334Medicaid
NY03629334Medicaid