| NPI | 1790509867 |
|---|---|
| Doing Business As | LIVE WELL PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JOHN MOUSSA Owner 718-968-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2024-11-14 |
| Last Update Date | 2024-11-14 |