| NPI | 1851432116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VYACHESLAV SHAMALOV Supervising Pharmacist 718-549-6709 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 028401) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2023-11-30 |