| NPI | 1689161630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VLADISLAVA KURSHEVA Ower 718-975-0781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 036541) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2018-07-19 |