| NPI | 1427450956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRINIVASA TALLA Managing Member 845-392-8254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2021-08-24 |