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General NPI Number Information
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NPI Number | 1649318767
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Entity Type | Organization
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Legal Business Name | THALES WELL PHARMACY INC
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 09/20/2007
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Provider Practice Location Address
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Address Line | 1785 NEW YORK AVE
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-1727
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Country | US
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Telephone | 631-549-4900
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Fax | 631-549-4197
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Provider Business Mailing Address
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Address Line | 1785 NEW YORK AVE
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-1727
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Country | US
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Telephone | 631-549-4900
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Fax | 631-549-4197
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MANSOOR ALAM MALIK
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Credential |
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Telephone | 631-549-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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