| NPI | 1114932720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA SOUSA Supervising Pharmacist 845-278-8224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NY 026459) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2008-02-14 |