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General NPI Number Information
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NPI Number | 1376655381
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Entity Type | Organization
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Legal Business Name | E T DRUGS INC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 173 BROAD ST
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City | STATEN ISLAND
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State | NY
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Zip | 10304-2057
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Country | US
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Telephone | 718-447-4127
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Fax | 718-273-1232
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Provider Business Mailing Address
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Address Line | 173 BROAD ST
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City | STATEN ISLAND
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State | NY
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Zip | 10304-2057
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Country | US
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Telephone | 718-447-4127
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Fax | 718-273-1232
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Authorized Official
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Title or Position | PRES
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Name | ETHAN ASEDO
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Credential | BS
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Telephone | 718-442-4127
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 017642
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License Number State | NY
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