Provider Demographics
NPI:1700350717
Name:FOREVER HEALTH PHARMACY II, LLC
Entity Type:Organization
Organization Name:FOREVER HEALTH PHARMACY II, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-673-8678
Mailing Address - Street 1:7224 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-5632
Mailing Address - Country:US
Mailing Address - Phone:347-673-8678
Mailing Address - Fax:347-673-8679
Practice Address - Street 1:7224 18TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5632
Practice Address - Country:US
Practice Address - Phone:347-673-8678
Practice Address - Fax:347-673-8679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy