NPI | 1518555994 |
---|---|
Doing Business As | 14TH ST PHARMACY |
Entity Type | Organization |
Authorized Contact | NIKOLAY KAZAKOV President 718-550-4668 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Enumeration Date | 2021-01-01 |
Last Update Date | 2022-02-01 |