Provider Demographics
NPI:1417429408
Name:LEAVITT PHARMACY INC
Entity Type:Organization
Organization Name:LEAVITT PHARMACY INC
Other - Org Name:LEAVITT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHUN
Authorized Official - Middle Name:
Authorized Official - Last Name:HU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-445-1888
Mailing Address - Street 1:3519 LEAVITT ST APT S1
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-2992
Mailing Address - Country:US
Mailing Address - Phone:718-445-1888
Mailing Address - Fax:718-445-8887
Practice Address - Street 1:3519 LEAVITT ST APT S1
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-2992
Practice Address - Country:US
Practice Address - Phone:718-445-1888
Practice Address - Fax:718-445-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-01
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy