Healthcare Provider Details

I. General information

NPI: 1982130043
Provider Name (Legal Business Name): 110 METRO DRUGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 05/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2061 ATLANTIC AVE
BROOKLYN NY
11233-3202
US

IV. Provider business mailing address

2061 ATLANTIC AVE
BROOKLYN NY
11233-3202
US

V. Phone/Fax

Practice location:
  • Phone: 516-528-3120
  • Fax:
Mailing address:
  • Phone: 516-528-3120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. MOHAMMAD ALI
Title or Position: PRESIDENT
Credential:
Phone: 516-528-3120