Provider Demographics
NPI:1992122600
Name:APPLE PHARMACY LLC
Entity type:Organization
Organization Name:APPLE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEASOOK
Authorized Official - Middle Name:
Authorized Official - Last Name:KWON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-939-3335
Mailing Address - Street 1:13221 41ST AVE
Mailing Address - Street 2:UNIT 1B
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5853
Mailing Address - Country:US
Mailing Address - Phone:718-939-3335
Mailing Address - Fax:718-939-3535
Practice Address - Street 1:13221 41ST AVE
Practice Address - Street 2:UNIT 1B
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5853
Practice Address - Country:US
Practice Address - Phone:718-939-3335
Practice Address - Fax:718-939-3535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-20
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0326763336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7107750001Medicare NSC