| NPI | 1528482213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY VALEVICH Supervising Pharmacist 718-393-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2021-04-07 |