Brentwood Pharmacy

LBN: Civa Drug Corp
Brentwood Pharmacy is an health care organization with primary practice located at 761 Suffolk Ave , Brentwood NY 11717-4409. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Civa Drug Corp can be contacted via phone (631) 273-3314, or through Thaker, Digesh via phone (631) 273-3314.

Contact Information

Primary practice address
761 Suffolk Ave Brentwood NY 11717-4409
Phone: (631) 273-3314
Fax: (631) 273-8863
Website:
Map and Directions
Authorized official contact:
Name: Thaker, Digesh
Phone: (631) 273-3314

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 017492 New York
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1174534739
LBN Legal business name Civa Drug Corp
DBA Doing business as Brentwood Pharmacy
Authorized official Thaker, Digesh
Entity Organization
Organization subpart 1 No
Enumeration date Aug 10th, 2006
Last updated May 22nd, 2024 - about 6 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174534739 NPPES
New York MEDICAID 00713240
New York Other 2061389

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