| NPI | 1891393484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IOSIF ILYAYEV President 929-354-0097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2025-08-27 |