Provider Demographics
NPI:1699033670
Name:PHARMACY 4U
Entity Type:Organization
Organization Name:PHARMACY 4U
Other - Org Name:PHARMACY 4 U INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVKOVSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-676-9770
Mailing Address - Street 1:1919A AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3905
Mailing Address - Country:US
Mailing Address - Phone:718-676-9770
Mailing Address - Fax:718-676-9767
Practice Address - Street 1:1919A AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3905
Practice Address - Country:US
Practice Address - Phone:718-676-9770
Practice Address - Fax:718-676-9767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336S0011X
NY0311903336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2148957OtherPK
NY03455447Medicaid