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General NPI Number Information
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NPI Number | 1689473928
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Entity Type | Organization
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Legal Business Name | LAURELTON RX INC
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 22401 141ST AVE
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City | LAURELTON
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State | NY
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Zip | 11413-2704
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Country | US
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Telephone | 718-747-8786
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Fax |
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Provider Business Mailing Address
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Address Line | 22401 141ST AVE
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City | LAURELTON
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State | NY
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Zip | 11413-2704
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Country | US
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Telephone | 718-413-2040
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Fax | 718-413-2041
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Authorized Official
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Title or Position | PRESIDENT
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Name | UMID OLIMOV
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Credential |
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Telephone | 718-413-2040
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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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