| NPI | 1104125574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORGE A. MARTILLO Pharmacist Manager 718-926-3432 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 47343) |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2011-03-24 |