| NPI | 1346641594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAZOL FATAKHOVA President 718-748-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2014-12-03 |