Organization · NPI-2

102 Center Care Pharmacy INC

Pharmacy · Corona, NY

NPI number1679260855

StatusActive

Last updated in NPPESApr 19, 2023

Details

NPI: 1679260855
Entity type: Organization (NPI-2)
Legal business name: 102 Center Care Pharmacy INC
Organization subpart: No
Enumeration date: Apr 19, 2023
Certification date: Apr 13, 2023
Last updated: Apr 19, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
333600000X	Pharmacy	–	–	Yes
332B00000X	Durable Medical Equipment & Medical Supplies	–	–
3336C0003X	Pharmacy, Community/Retail Pharmacy	–	–

Other names

Center Care Pharmacy (Doing Business As)

Practice location

102-05b Northern Blvd
Corona, NY 11368

Phone 718-587-9010 · Fax 718-587-9009

Mailing address

102-05b Northern Blvd
Corona, NY 11368

Phone 718-587-9010 · Fax 718-587-9009

Authorized official

Miguel Angel Baron
Owner/Pharmacist
7185879010

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