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General NPI Number Information
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NPI Number | 1760469308
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Entity Type | Organization
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Legal Business Name | L. FERNANDEZ FARMACIA, INC
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Dates
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Enumeration Date | 12/25/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12323 LIBERTY AVE
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City | SOUTH RICHMOND HILL
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State | NY
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Zip | 11419-2115
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Country | US
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Telephone | 718-738-0500
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Fax | 718-738-5327
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Provider Business Mailing Address
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Address Line | 12323 LIBERTY AVE
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City | SOUTH RICHMOND HILL
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State | NY
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Zip | 11419-2115
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Country | US
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Telephone | 718-738-0500
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Fax | 718-738-5327
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARITZA A SALCEDO
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Credential |
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Telephone | 718-738-0500
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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 | 019142
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License Number State | NY
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