| NPI | 1952195703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BORUKHOV Owner 917-584-4030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2025-04-07 |
| Last Update Date | 2025-08-04 |