Provider Demographics
NPI:1376225805
Name:NUCARE LTC LLC
Entity Type:Organization
Organization Name:NUCARE LTC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHVARTSSHTEYN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-207-6310
Mailing Address - Street 1:1633 DUTCH BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-5008
Mailing Address - Country:US
Mailing Address - Phone:516-620-1315
Mailing Address - Fax:516-620-4799
Practice Address - Street 1:1633 DUTCH BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-5008
Practice Address - Country:US
Practice Address - Phone:516-620-1315
Practice Address - Fax:516-620-4799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY040410OtherPHARMACY STATE