| NPI | 1215062484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH EVANS Supervising Pharmacist 718-671-6410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |