| NPI | 1053016410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJENDRAPRASAD VENIGALLA Owner/President 347-528-8893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2023-04-04 |