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General NPI Number Information
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NPI Number | 1669408951
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Entity Type | Organization
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Legal Business Name | CANAAN PHARMACY INC.
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 04/27/2018
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Provider Practice Location Address
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Address Line | 6914 5TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11209-1507
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Country | US
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Telephone | 718-779-4523
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Fax | 718-779-7814
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Provider Business Mailing Address
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Address Line | 6914 5TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11209-1507
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Country | US
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Telephone | 718-779-4523
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Fax | 718-779-7814
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Authorized Official
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Title or Position | DIRECTOR
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Name | KRISHNA CHALUVADI
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Credential |
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Telephone | 718-293-9596
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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 | 017260
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License Number State | NY
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