Healthcare Provider Details
I. General information
NPI: 1952560724
Provider Name (Legal Business Name): 370 PHARMACY CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/05/2008
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
370 LEXINGTON AVE
NEW YORK NY
10017-6503
US
IV. Provider business mailing address
370 LEXINGTON AVE
NEW YORK NY
10017-6503
US
V. Phone/Fax
- Phone: 212-286-8400
- Fax: 212-286-8688
- Phone: 212-286-8400
- Fax: 212-286-8688
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 028883 |
| License Number State | NY |
VIII. Authorized Official
Name:
ALEX
NOSKOV
Title or Position: PRESIDENT
Credential: PHRMD
Phone: 212-286-8400