| NPI | 1861512527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FIDELIS TONY IBEH Owner 718-826-6117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 040602) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |