Provider Demographics
NPI:1407891195
Name:S&E DRUGS,INC.
Entity Type:Organization
Organization Name:S&E DRUGS,INC.
Other - Org Name:FIVE STAR PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDWIGE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DORIME
Authorized Official - Suffix:
Authorized Official - Credentials:RPH,
Authorized Official - Phone:718-398-9000
Mailing Address - Street 1:1202 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-2295
Mailing Address - Country:US
Mailing Address - Phone:718-398-9000
Mailing Address - Fax:718-398-0122
Practice Address - Street 1:1202 FULTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-2295
Practice Address - Country:US
Practice Address - Phone:718-398-9000
Practice Address - Fax:718-398-0122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021106332BP3500X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01529946Medicaid
NY5341470001Medicare NSC
NY01529946Medicaid