| NPI | 1043541550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRINIVASA TALLA Supervising Pharmacist 845-548-0801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 029645) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2018-04-02 |