| NPI | 1003966821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRVICE AHMAD Owner/ Supervising Pharmacist 718-699-5099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2023-07-18 |