| NPI | 1669817938 |
|---|---|
| Former Legal Business Name | PHS MEDICAL SERVICES, P.C. |
| Entity Type | Organization |
| Authorized Contact | JAY COWAN Medical Director 347-774-7015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2013-05-01 |