108 Pharmacy INC
Pharmacy, Long Term Care Pharmacy in Corona, NY. Organization (NPI-2).
NPI number1407626070
StatusActive
Last updated in NPPESJan 4, 2024
Details
- NPI
- 1407626070
- Entity type
- Organization (NPI-2)
- Legal business name
- 108 Pharmacy INC
- Organization subpart
- No
- Enumeration date
- Jan 4, 2024
- Certification date
- Jan 4, 2024
- Last updated
- Jan 4, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336L0003X | Pharmacy, Long Term Care Pharmacy | – | – | Yes |
Practice location
4502 108th StCorona, NY 11368-2917
Phone 718-847-1982 · Fax 718-228-4985
Mailing address
4502 108th StCorona, NY 11368-2917
Phone 718-847-1982 · Fax 718-228-4985
Authorized official
Roman Badalov
Owner
6467520490
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