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General NPI Number Information
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NPI Number | 1376854323
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Entity Type | Organization
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Legal Business Name | NYC WHOLESALE INC
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Dates
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Enumeration Date | 06/24/2010
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 63-52 WOODHAVEN BLVD.
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City | REGO PARK
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State | NY
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Zip | 11374
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Country | US
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Telephone | 718-739-0300
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Fax | 718-739-0301
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Provider Business Mailing Address
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Address Line | 63-52 WOODHAVEN BLVD.
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City | REGO PARK
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State | NY
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Zip | 11374
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Country | US
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Telephone | 718-739-0300
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Fax | 718-739-0301
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | GEORGE CHU
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Credential |
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Telephone | 484-401-2773
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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 | 17-030055
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License Number State | NY
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