| NPI | 1013272095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER NYAZOV President 718-255-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 031371) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| 3336M0003X Pharmacy Managed Care Organization Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| 333600000X Pharmacy | |
| 332000000X Military/U.S. Coast Guard Pharmacy | |
| 332100000X Department of Veterans Affairs (VA) Pharmacy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition | |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2025-09-19 |