| NPI | 1861623662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMON BATUROV Pharmacist 718-525-5005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 048499) |
| 333600000X Pharmacy | |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2019-08-02 |