Provider Demographics
NPI:1841205598
Name:LEVINS PHARMACY INC
Entity Type:Organization
Organization Name:LEVINS PHARMACY INC
Other - Org Name:LEVINS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJENDRAPRASAD
Authorized Official - Middle Name:
Authorized Official - Last Name:VENIGALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-528-8893
Mailing Address - Street 1:364 LONG BEACH RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2230
Mailing Address - Country:US
Mailing Address - Phone:516-766-2288
Mailing Address - Fax:516-766-0687
Practice Address - Street 1:364 LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2230
Practice Address - Country:US
Practice Address - Phone:516-766-2288
Practice Address - Fax:516-766-0687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0215093336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01382838Medicaid
2064683OtherPK
NY01382838Medicaid