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General NPI Number Information
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NPI Number | 1710413109
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Entity Type | Organization
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Legal Business Name | KINGS 7TH AVE PHARMACY INC
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Dates
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Enumeration Date | 05/04/2017
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 300 7TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11215-7251
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Country | US
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Telephone | 718-499-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 300 7TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11215-7251
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Country | US
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Telephone | 718-499-5200
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Fax | 718-499-1299
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | RONALD DELGAUDIO
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Credential |
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Telephone | 917-921-5656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 035456
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 035456
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License Number State | NY
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