| NPI | 1104933795 |
|---|---|
| Doing Business As | FULLER DRUG STORE |
| Entity Type | Organization |
| Authorized Contact | PARTHIV SHAH Sp 718-292-4244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 026980) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2016-09-22 |