| NPI | 1154895837 |
|---|---|
| Doing Business As | MAIN STREET PHARMACY |
| Entity Type | Organization |
| Authorized Contact | RAVEENDRA REDDY BOMMU President 203-919-3124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2021-08-27 |