| NPI | 1972931269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX CHARLES Supervising Pharmacist 718-309-3943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 032330) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2014-11-24 |