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General NPI Number Information
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NPI Number | 1437394822
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Entity Type | Organization
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Legal Business Name | RIDGEWOOD CITY PHARMACY INC.
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Dates
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Enumeration Date | 12/13/2008
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 775 SENECA AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-4127
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Country | US
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Telephone | 718-381-7766
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Fax | 718-381-7765
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Provider Business Mailing Address
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Address Line | 775 SENECA AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-4127
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Country | US
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Telephone | 718-381-7766
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Fax | 718-381-7765
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Authorized Official
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Title or Position | OWNER
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Name | PADMA PALLAPOLU
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Credential |
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Telephone | 718-381-7766
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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 | 029140
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License Number State | NY
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