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General NPI Number Information
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NPI Number | 1114204575
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Entity Type | Organization
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Legal Business Name | DM PHARMACY,INC.
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Dates
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Enumeration Date | 11/12/2011
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Last Update Date | 11/12/2011
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Provider Practice Location Address
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Address Line | 960 SIMON PL
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City | WANTAGH
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State | NY
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Zip | 11793-1645
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Country | US
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Telephone | 516-508-6737
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Fax |
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Provider Business Mailing Address
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Address Line | 960 SIMON PL
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City | WANTAGH
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State | NY
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Zip | 11793-1645
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Country | US
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Telephone | 516-508-6737
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. MO A DALIA
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Credential |
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Telephone | 718-221-6814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 040895
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License Number State | NY
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