Provider Demographics
NPI:1013014950
Name:NATURES APOTHECARY INC
Entity Type:Organization
Organization Name:NATURES APOTHECARY INC
Other - Org Name:NATURES EMPORIUM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:AZARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-375-7877
Mailing Address - Street 1:1612 E 16TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1108
Mailing Address - Country:US
Mailing Address - Phone:718-375-7877
Mailing Address - Fax:718-382-5445
Practice Address - Street 1:1612 E 16TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1108
Practice Address - Country:US
Practice Address - Phone:718-375-7877
Practice Address - Fax:718-382-5445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025612333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02384265Medicaid
3330331OtherOTHER ID NUMBER-COMMERCIAL NUMBER
NY02384265Medicaid