Provider Demographics
NPI:1871662312
Name:KEVIN & MILTON PHARMACY INC
Entity Type:Organization
Organization Name:KEVIN & MILTON PHARMACY INC
Other - Org Name:BATISH DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MATHAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-739-7505
Mailing Address - Street 1:378 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-1311
Mailing Address - Country:US
Mailing Address - Phone:718-623-8930
Mailing Address - Fax:
Practice Address - Street 1:378 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-1311
Practice Address - Country:US
Practice Address - Phone:718-623-8930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02779413Medicaid