| NPI | 1922147974 |
|---|---|
| Doing Business As | BURNSIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | VARGHESE ABRAHAM Supervising Pharmacist 718-731-8505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 024771) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-04-05 |