| NPI | 1326537937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENIAMIN AVEZOV President 347-916-1895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-05-09 |