| NPI | 1508648387 |
|---|---|
| Doing Business As | COLUMBUS AVE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | TEIMURAZ DANELIA President 631-397-6255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2026-02-04 |