| NPI | 1255088514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERSIDA BELLO Supervising Pharmacist 718-992-8182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2022-03-07 |
| Last Update Date | 2022-03-07 |