Fortune Medical Supply LLC
Pharmacy, Clinic Pharmacy in Long Island City, NY. Organization (NPI-2).
NPI number1104736115
StatusActive
Last updated in NPPESSep 21, 2026
Details
- NPI
- 1104736115
- Entity type
- Organization (NPI-2)
- Legal business name
- Fortune Medical Supply LLC
- Organization subpart
- No
- Enumeration date
- Sep 10, 2026
- Certification date
- Sep 21, 2026
- Last updated
- Sep 21, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0002X | Pharmacy, Clinic Pharmacy | – | – | Yes |
Practice location
310 26th AveLong Island City, NY 11102-4120
Phone 646-344-0609
Mailing address
310 26th AveLong Island City, NY 11102-4120
Phone 646-344-0609
Authorized official
Eugene Barnes
Ceo
6463440609
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