| NPI | 1417624297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELMOATAZBELLAH A TAMMAA Pharmacist In Charge 631-572-7973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2021-08-27 |
| Last Update Date | 2022-05-06 |