| NPI | 1629884721 |
|---|---|
| Doing Business As | BOOM PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DAVE WATTS President 718-292-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2024-12-04 |
| Last Update Date | 2024-12-04 |