| NPI | 1497820112 |
|---|---|
| Former Legal Business Name | PHARMACY |
| Entity Type | Organization |
| Authorized Contact | IRA S WIENER Owner Pharmacy 718-256-8423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NY 15454) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2009-12-24 |