Provider Demographics
NPI:1518249572
Name:510 FULTON AVE CORP
Entity Type:Organization
Organization Name:510 FULTON AVE CORP
Other - Org Name:BEST CHOICE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KYLIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:ARCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-724-0102
Mailing Address - Street 1:510 FULTON AVE
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4364
Mailing Address - Country:US
Mailing Address - Phone:516-307-8430
Mailing Address - Fax:
Practice Address - Street 1:510 FULTON AVE
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-4364
Practice Address - Country:US
Practice Address - Phone:516-307-8430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-15
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6608520001Medicare NSC