| NPI | 1962240341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL ERIC MAMMON Owner 718-599-5991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2024-07-18 |
| Last Update Date | 2025-03-17 |