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General NPI Number Information
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NPI Number | 1427192376
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Entity Type | Organization
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Legal Business Name | SECOND CENTURY SERVICES CORPORATION
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 14601 45TH AVE
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City | FLUSHING
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State | NY
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Zip | 11355-2200
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Country | US
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Telephone | 718-353-3160
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Fax | 718-353-0647
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Provider Business Mailing Address
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Address Line | 14601 45TH AVE
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City | FLUSHING
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State | NY
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Zip | 11355-2200
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Country | US
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Telephone | 718-353-3160
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Fax | 718-353-0647
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST
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Name | MR. WAIMING WU
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Credential |
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Telephone | 718-353-3160
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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 | 019472
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License Number State | NY
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