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General NPI Number Information
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NPI Number | 1225088909
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Entity Type | Organization
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Legal Business Name | BOREUM DRUGS CORP
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 01/29/2016
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Provider Practice Location Address
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Address Line | 194 UNION AVE
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City | BROOKLYN
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State | NY
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Zip | 11211-7412
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Country | US
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Telephone | 718-387-8288
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Fax | 718-387-6788
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Provider Business Mailing Address
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Address Line | 194 UNION AVE
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City | BROOKLYN
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State | NY
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Zip | 11211-7412
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Country | US
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Telephone | 718-387-8288
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Fax | 718-387-6788
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Authorized Official
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Title or Position | OWNER
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Name | RICK TSE
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Credential | RPH
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Telephone | 718-501-2204
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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 | 027749
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License Number State | NY
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