| NPI | 1023599321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIRANJIVI B JANNU Director Of Pharmacy 646-673-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH31592) |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2025-03-12 |