| NPI | 1689047565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDUART BORUKHOV President 718-658-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 034510) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2016-06-21 |