| NPI | 1356377089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD LA FONTAINE Pharmacy Director 718-960-6180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NY 000564) |
| Additional Taxonomies | 3336I0012X Pharmacy, Institutional Pharmacy |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2020-08-22 |