| NPI | 1699082057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BORIS ASHIROV Owner 718-779-4450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 030372) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2012-04-04 |