| NPI | 1740394634 |
|---|---|
| Doing Business As | 110 PHARMACY AND SURGICAL |
| Entity Type | Organization |
| Authorized Contact | RAJENDRAPRASAD VENIGALLA President 631-421-5454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 016281) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2021-02-05 |