| NPI | 1669798047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESDRAS OBAS Pharmacist 646-359-1976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-04-11 |
| Last Update Date | 2013-01-24 |