| NPI | 1033127352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENE MAZEPA Supervising Pharmacist 718-282-4777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 027498) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NY 027498) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2020-08-24 |