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General NPI Number Information
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NPI Number | 1013236132
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Entity Type | Organization
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Legal Business Name | UNION ST. PHARMACY
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Dates
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Enumeration Date | 05/28/2010
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Last Update Date | 06/27/2011
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Provider Practice Location Address
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Address Line | 4170 MAIN ST A2
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City | FLUSHING
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State | NY
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Zip | 11355-3837
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Country | US
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Telephone | 718-321-8830
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Fax | 718-321-8815
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Provider Business Mailing Address
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Address Line | 4170 MAIN ST A2
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City | FLUSHING
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State | NY
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Zip | 11355-3837
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Country | US
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Telephone | 718-321-8830
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Fax | 718-321-8815
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Authorized Official
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Title or Position | PRESIDENT / SUPERVISING PHARMACIST
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Name | MR. VINCE S CHEUNG
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Credential |
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Telephone | 718-321-8830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 030026
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License Number State | NY
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