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General NPI Number Information
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NPI Number | 1730234006
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Entity Type | Organization
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Legal Business Name | MEDWIN PHARMACY INC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6638 GRAND AVE
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City | MASPETH
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State | NY
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Zip | 11378-2531
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Country | US
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Telephone | 718-424-8273
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Fax | 718-424-1133
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Provider Business Mailing Address
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Address Line | 6638 GRAND AVE
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City | MASPETH
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State | NY
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Zip | 11378-2531
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Country | US
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Telephone | 718-424-8273
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Fax | 718-424-1133
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST
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Name | MR. WILLIAM GECHOFF
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Credential | R.PH
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Telephone | 718-424-8273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 023496
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License Number State | NY
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