| NPI | 1407365679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINNIE DAM Chief Pharmacy Officer 347-610-9820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NY 035768) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 035768) |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: NY 035768) | |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2020-10-05 |