| NPI | 1023773421 |
|---|---|
| Doing Business As | MIRAGE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SOLOMON MOSES President 718-487-3050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2021-11-02 |