| NPI | 1710590849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAVITHA KONDAPALLY Member 718-500-4928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-08-28 |