| NPI | 1598595118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN BLOND Manager 718-513-6644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2024-08-07 |
| Last Update Date | 2024-08-07 |