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General NPI Number Information
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NPI Number | 1407285216
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Entity Type | Organization
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Legal Business Name | RICHMOND VALLEY PHARMACY INC
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Dates
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Enumeration Date | 11/02/2013
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Last Update Date | 06/19/2021
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Provider Practice Location Address
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Address Line | 4888 ARTHUR KILL RD
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City | STATEN ISLAND
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State | NY
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Zip | 10309-2633
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Country | US
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Telephone | 718-967-9607
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Fax | 718-967-9620
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Provider Business Mailing Address
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Address Line | 4888 ARTHUR KILL RD
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City | STATEN ISLAND
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State | NY
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Zip | 10309-2633
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Country | US
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Telephone | 718-967-9607
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Fax | 718-967-9620
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Authorized Official
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Title or Position | PRESIDENT
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Name | ISLAM MOHAMED
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Credential |
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Telephone | 718-967-9607
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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 | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 032248
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License Number State | NY
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