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General NPI Number Information
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NPI Number | 1396497756
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Entity Type | Organization
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Legal Business Name | RIDGE EZ PHARMACY INC.
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Dates
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Enumeration Date | 01/26/2022
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Last Update Date | 01/26/2022
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Provider Practice Location Address
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Address Line | 6923 4TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11209-1501
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Country | US
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Telephone | 718-333-5356
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Fax |
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Provider Business Mailing Address
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Address Line | 8834 FORT HAMILTON PKWY
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City | BROOKLYN
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State | NY
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Zip | 11209-6004
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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 | SUPERVISING PHARMACIST
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Name | DR. AMRR S BAHLOOL JR.
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Credential | PHARM D
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Telephone | 347-806-6772
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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 |
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License Number State |
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