| NPI | 1073177309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT MAVASHEV President 718-444-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2021-09-30 |