NPI | 1992117451 |
---|---|
Doing Business As | MODERN MEDICINE RX |
Entity Type | Organization |
Authorized Contact | KLARA REIZIS Owner/Pharmacist/AO 917-217-3908 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Additional Taxonomies | 333600000X Pharmacy |
3336C0004X Pharmacy, Compounding Pharmacy (Licence: NJ 28RS00733400) | |
3336S0011X Pharmacy, Specialty Pharmacy | |
Enumeration Date | 2014-06-02 |
Last Update Date | 2020-04-27 |