| NPI | 1225613631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN LAM Supervising Pharmacist 718-618-7081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2021-03-17 |
| Last Update Date | 2021-03-17 |