Provider Demographics
NPI:1841424397
Name:BED PHARMACY EAST, LLC
Entity Type:Organization
Organization Name:BED PHARMACY EAST, LLC
Other - Org Name:KINGS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WAX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-431-6633
Mailing Address - Street 1:639 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-2512
Mailing Address - Country:US
Mailing Address - Phone:516-431-6633
Mailing Address - Fax:516-889-6905
Practice Address - Street 1:639 E PARK AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-2512
Practice Address - Country:US
Practice Address - Phone:516-431-6633
Practice Address - Fax:516-889-6905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy