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General NPI Number Information
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NPI Number | 1801945282
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Entity Type | Organization
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Legal Business Name | TOMPKINSVILLE PHARMACY INC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 45 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10301
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Country | US
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Telephone | 718-727-0430
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Fax | 718-727-0667
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Provider Business Mailing Address
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Address Line | 45 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10301
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Country | US
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Telephone | 718-727-0430
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Fax | 718-727-0667
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Authorized Official
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Title or Position | PRESIDENT PHARMACIST
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Name | MR. ESAR GANGADIN
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Credential | PHARMACIST
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Telephone | 718-727-0430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 037479
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License Number State | NY
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