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General NPI Number Information
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NPI Number | 1417962044
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Entity Type | Organization
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Legal Business Name | ISLA DRUG STORES INC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 05/20/2014
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Provider Practice Location Address
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Address Line | 1994 3RD AVE
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City | NEW YORK
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State | NY
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Zip | 10029-3644
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Country | US
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Telephone | 212-427-7123
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Fax | 212-828-9359
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Provider Business Mailing Address
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Address Line | 1994 3RD AVE
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City | NEW YORK
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State | NY
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Zip | 10029-3644
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Country | US
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Telephone | 212-427-7123
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Fax | 212-828-9359
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Authorized Official
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Title or Position | VP
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Name | RAYMOND CANALS
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Credential |
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Telephone | 212-427-7123
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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 | 013251
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License Number State | NY
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