Organization · NPI-2

90-15 Roosevelt Pharmacy Corp

Pharmacy, Community/Retail Pharmacy · Jackson Heights, NY

NPI number1831201847
StatusActive
Last updated in NPPESSep 19, 2025

Details

NPI
1831201847
Entity type
Organization (NPI-2)
Legal business name
90-15 Roosevelt Pharmacy Corp
Organization subpart
No
Enumeration date
Aug 31, 2006
Certification date
Jun 28, 2023
Last updated
Sep 19, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail Pharmacy024229NYYes
333600000X Pharmacy––

Other names

  • Mi Farmacia (Doing Business As)

Practice location

9015 Roosevelt Ave
Jackson Heights, NY 11372-7938

Phone 718-429-7666 · Fax 718-898-9505

Mailing address

9015 Roosevelt Ave
Jackson Heights, NY 11372-7938

Phone 718-429-7666 · Fax 718-898-9505

Authorized official

Elena Luna
President
7184297666

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