Organization · NPI-2

16th Ave Pharmacy LLC

Pharmacy, Community/Retail Pharmacy · Brooklyn, NY

NPI number1285254367
StatusActive
Last updated in NPPESApr 20, 2020

Details

NPI
1285254367
Entity type
Organization (NPI-2)
Legal business name
16th Ave Pharmacy LLC
Organization subpart
No
Enumeration date
Apr 20, 2020
Certification date
Apr 20, 2020
Last updated
Apr 20, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail Pharmacy––Yes

Practice location

4605 16th Ave
Brooklyn, NY 11204-1105

Phone 718-686-8000 · Fax 718-686-8001

Mailing address

4605 16th Ave
Brooklyn, NY 11204-1105

Phone 718-686-8000 · Fax 718-686-8001

Authorized official

Solomon Gulyamov
Owner
7186868000

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