| NPI | 1811762131 |
|---|---|
| Doing Business As | PHOENIX RX |
| Entity Type | Organization |
| Authorized Contact | GABRIEL POLTIELOV President 201-453-3114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2023-11-16 |
| Last Update Date | 2024-02-21 |