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General NPI Number Information
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NPI Number | 1366592727
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Entity Type | Organization
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Legal Business Name | GOWANUS PHARMACY LLC
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 236 HOYT ST
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City | BROOKLYN
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State | NY
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Zip | 11217-2913
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Country | US
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Telephone | 718-797-3637
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Fax | 718-797-3638
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Provider Business Mailing Address
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Address Line | 236 HOYT ST
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City | BROOKLYN
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State | NY
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Zip | 11217-2913
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER AND SP
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Name | FRANCIS NNOCHIRI
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Credential |
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Telephone | 718-797-3637
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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 | 028099
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License Number State | NY
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