| NPI | 1194499343 |
|---|---|
| Doing Business As | 77 PHARMACY |
| Entity Type | Organization |
| Authorized Contact | RONALD RIVAS Owner 718-684-1595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2024-11-21 |