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General NPI Number Information
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NPI Number | 1629173372
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Entity Type | Organization
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Legal Business Name | CMD ENTERPRISES LLC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 02/15/2008
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Provider Practice Location Address
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Address Line | 136-10/12 38TH AVENUE
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City | FLUSHING
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State | NY
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Zip | 11354
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Country | US
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Telephone | 718-353-5737
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Fax | 718-353-6197
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Provider Business Mailing Address
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Address Line | 136-10/12 38TH AVENUE
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City | FLUSHING
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State | NY
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Zip | 11354
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Country | US
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Telephone | 718-353-5737
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Fax | 718-353-6197
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Authorized Official
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Title or Position | MANAGEMENT MEMBER
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Name | MR. WILLIMA Y. CHOI
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Credential | RPH
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Telephone | 718-353-5737
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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 | 027008
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License Number State | NY
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