| NPI | 1225437650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABIMBOLA AYORINDE Supervising Pharmacist 718424-868-4036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 059015) |
| Additional Taxonomies | 282NC0060X General Acute Care Hospital Critical Access (Licence: NY 059015) |
| 3336C0004X Pharmacy Compounding Pharmacy (Licence: NY 059015) | |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |