Provider Demographics
NPI:1386741221
Name:CROWN CHEMISTS LTD
Entity type:Organization
Organization Name:CROWN CHEMISTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHARMACIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOS
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAKOSHIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-278-6777
Mailing Address - Street 1:3320 DITMARS BLVD
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-2106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3320 DITMARS BLVD
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-2106
Practice Address - Country:US
Practice Address - Phone:718-278-6777
Practice Address - Fax:718-278-8716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026334333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3336434OtherOTHER ID NUMBER-COMMERCIAL NUMBER
NY2522030Medicaid
NY5077350001Medicare NSC