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General NPI Number Information
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NPI Number | 1093856866
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Entity Type | Organization
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Legal Business Name | PARK HEALTH PHARMACY INC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 12/07/2017
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Provider Practice Location Address
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Address Line | 13124 ROCKAWAY BLVD
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City | SOUTH OZONE PARK
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State | NY
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Zip | 11420-2932
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Country | US
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Telephone | 718-322-3261
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Fax | 718-322-3261
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Provider Business Mailing Address
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Address Line | 13124 ROCKAWAY BLVD
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City | SOUTH OZONE PARK
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State | NY
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Zip | 11420-2932
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Country | US
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Telephone | 718-322-3261
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Fax | 718-322-3261
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Authorized Official
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Title or Position | PHARMACIST
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Name | MRS. PREETHA VARGHESE
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Credential | PHARMACY
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Telephone | 718-322-3261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 046310
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License Number State | NY
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