| NPI | 1447113675 |
|---|---|
| Doing Business As | 108 PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SIENKHAI SIONOV Owner 718-847-1982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2025-12-04 |
| Last Update Date | 2026-03-24 |