Provider Demographics
NPI:1689678138
Name:JIM & PHIL'S FAMILY PHARMACY LTD.
Entity Type:Organization
Organization Name:JIM & PHIL'S FAMILY PHARMACY LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED PHARRMACIST, & CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHIFFER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH JD
Authorized Official - Phone:718-492-0900
Mailing Address - Street 1:6109 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4609
Mailing Address - Country:US
Mailing Address - Phone:718-492-0900
Mailing Address - Fax:
Practice Address - Street 1:6109 5TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4609
Practice Address - Country:US
Practice Address - Phone:718-492-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16426333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3366615OtherNCPDP ID
NY00363204Medicaid
NY16426OtherPHARMACY LICENSE
NY16426OtherPHARMACY LICENSE
0333600001Medicare NSC