| NPI | 1326654054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NGOZI AGBASIONWE Pharmacist 718-400-9144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |