Provider Demographics
NPI:1841207933
Name:METROCARE PHARMACY, INC
Entity Type:Organization
Organization Name:METROCARE PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:TU TRINH
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIEU
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:646-267-8479
Mailing Address - Street 1:2112B 36TH AVE
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11106-4422
Mailing Address - Country:US
Mailing Address - Phone:718-606-0068
Mailing Address - Fax:718-606-0069
Practice Address - Street 1:2112B 36TH AVE
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11106-4422
Practice Address - Country:US
Practice Address - Phone:718-606-0068
Practice Address - Fax:718-606-0069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027405183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5516160001Medicare NSC