| NPI | 1851634950 |
|---|---|
| Doing Business As | PINEBROOK PHARMACY |
| Entity Type | Organization |
| Authorized Contact | RAVIKUMAR MAMIDELA President 718-992-8182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NY 031942) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2014-10-30 |