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General NPI Number Information
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NPI Number | 1518095827
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Entity Type | Organization
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Legal Business Name | ADUWA PHARMACY INC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 114-10 SUTPHIN BLVD.
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City | JAMAICA
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State | NY
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Zip | 11434
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Country | US
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Telephone | 178-322-9709
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Fax | 718-322-5115
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Provider Business Mailing Address
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Address Line | 114-10 SUTPHIN BLVD
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City | JAMAICA
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State | NY
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Zip | 11434
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Country | US
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Telephone | 178-322-9709
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Fax | 718-322-5115
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Authorized Official
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Title or Position | MANAGER
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Name | PETER M PERVAZ
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Credential |
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Telephone | 718-322-9709
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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 | 023542
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License Number State | NY
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