Provider Demographics
NPI:1972518512
Name:S AND D NATURES PHARMACIE INC
Entity Type:Organization
Organization Name:S AND D NATURES PHARMACIE INC
Other - Org Name:S AND T PHARMACIE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALL
Authorized Official - Middle Name:
Authorized Official - Last Name:STFLEUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-756-6026
Mailing Address - Street 1:391 EASTERN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-4570
Mailing Address - Country:US
Mailing Address - Phone:718-756-6026
Mailing Address - Fax:719-953-3720
Practice Address - Street 1:391 EASTERN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-4570
Practice Address - Country:US
Practice Address - Phone:718-756-6026
Practice Address - Fax:719-953-3720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0277643336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2061849OtherPK
NY2998236Medicaid
NY02998236Medicaid
NY5683750001Medicare NSC