| NPI | 1831130269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANSOUR MANSOUR Vice Pres 718-607-7990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NY 027516) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336M0003X Pharmacy, Managed Care Organization Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2020-08-22 |