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General NPI Number Information
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NPI Number | 1235318940
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Entity Type | Organization
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Legal Business Name | M & O PHARMACY INC
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 9 S MIDDLE NECK RD
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City | GREAT NECK
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State | NY
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Zip | 11021-3455
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Country | US
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Telephone | 516-829-5900
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Fax | 516-829-5901
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Provider Business Mailing Address
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Address Line | 9 S MIDDLE NECK RD
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City | GREAT NECK
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State | NY
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Zip | 11021-3455
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Country | US
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Telephone | 516-829-5900
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Fax | 516-829-5901
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. LEV ZAVULUNOV
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Credential |
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Telephone | 516-829-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 028586
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License Number State | NY
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