Lake Success Rx Corp
Pharmacy, Community/Retail Pharmacy in New Hyde Park, NY. Organization (NPI-2).
NPI number1508526328
StatusActive
Last updated in NPPESDec 20, 2021
Details
- NPI
- 1508526328
- Entity type
- Organization (NPI-2)
- Legal business name
- Lake Success Rx Corp
- Organization subpart
- No
- Enumeration date
- Dec 20, 2021
- Certification date
- Dec 20, 2021
- Last updated
- Dec 20, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – | Yes |
Other names
- Pharmaconic (Doing Business As)
Practice location
1566a Union TpkeNew Hyde Park, NY 11040-1762
Phone 516-502-4170 · Fax 516-502-4168
Mailing address
1566a Union TpkeNew Hyde Park, NY 11040-1762
Phone 516-502-4170 · Fax 516-502-4168
Authorized official
Stanislav Zavulunov
President
5165024170
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