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General NPI Number Information
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NPI Number | 1619490935
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Entity Type | Organization
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Legal Business Name | EXCELLENT CHOICE PHARMACY CORP
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Dates
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Enumeration Date | 07/18/2017
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Last Update Date | 11/30/2017
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Provider Practice Location Address
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Address Line | 409 ROCKAWAY AVE
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City | BROOKLYN
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State | NY
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Zip | 11212-5635
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Country | US
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Telephone | 646-244-6050
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Fax |
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Provider Business Mailing Address
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Address Line | 409 ROCKAWAY AVE
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City | BROOKLYN
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State | NY
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Zip | 11212-5635
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARKADIY KHAIMOV
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Credential |
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Telephone | 347-533-6828
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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 |
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License Number State |
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