| NPI | 1801162375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVE WATTS Vice President 718-292-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 031260) |
| Additional Taxonomies | 3336C0002X Pharmacy Clinic Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2024-12-04 |