Provider Demographics
NPI:1285170498
Name:MEDPLUS 2 PHARMACY INC
Entity type:Organization
Organization Name:MEDPLUS 2 PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WENLI
Authorized Official - Middle Name:
Authorized Official - Last Name:XIAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-460-8329
Mailing Address - Street 1:13347 SANFORD AVE STE C1D
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5870
Mailing Address - Country:US
Mailing Address - Phone:718-460-8329
Mailing Address - Fax:718-460-6279
Practice Address - Street 1:13347 SANFORD AVE STE C1D
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5870
Practice Address - Country:US
Practice Address - Phone:718-460-8329
Practice Address - Fax:718-460-6279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0352833336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2168993OtherPK