Organization · NPI-2

Brand Rx Pharmacy Corp

Pharmacy, Community/Retail Pharmacy · Corona, NY

NPI number1063940443
StatusActive
Last updated in NPPESJun 3, 2020

Details

NPI
1063940443
Entity type
Organization (NPI-2)
Legal business name
Brand Rx Pharmacy Corp
Organization subpart
No
Enumeration date
May 30, 2017
Certification date
Jun 3, 2020
Last updated
Jun 3, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail Pharmacy035409NYYes

Practice location

97-05 A 57th Avenue
Corona, NY 11368

Phone 718-393-2300 · Fax 718-393-2311

Mailing address

97-05 A 57th Avenue
Corona, NY 11368

Phone 718-393-2300 · Fax 718-393-2311

Authorized official

Alisho Fattahov
President
7183932300

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