| NPI | 1144038803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IGOR MATATOV Supervising Pharmacist 347-836-3966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2024-12-26 |
| Last Update Date | 2024-12-26 |