| NPI | 1245630706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY WILLIAM RODZEVIK Pharmacist 631-275-3889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NC 24545) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2014-09-02 |