| NPI | 1417059072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELVIO JOEL VIVAS President 718-898-9833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 019629) |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2017-03-03 |