| NPI | 1861900383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRIGORIY YUABOV President 718-777-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 035989) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: NY 035989) | |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: NY 035989) | |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2018-01-18 |