Provider Demographics
NPI:1790596336
Name:CHURCH AVE PHARMACY INC LTC
Entity type:Organization
Organization Name:CHURCH AVE PHARMACY INC LTC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ZOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRITSKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-941-2200
Mailing Address - Street 1:1810 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-3706
Mailing Address - Country:US
Mailing Address - Phone:718-314-8001
Mailing Address - Fax:718-941-2300
Practice Address - Street 1:1810 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-3706
Practice Address - Country:US
Practice Address - Phone:718-314-8001
Practice Address - Fax:718-941-2300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-14
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care