| NPI | 1043960370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH PAUL Pharmacy Manager 917-412-6622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2022-04-06 |