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General NPI Number Information
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NPI Number | 1841235280
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Entity Type | Organization
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Legal Business Name | ARLO DRUG STORE OF L I INC
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 03/03/2020
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Provider Practice Location Address
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Address Line | 1022 PARK BLVD
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City | MASSAPEQUA PARK
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State | NY
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Zip | 11762-2784
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Country | US
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Telephone | 516-798-9444
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Fax | 516-798-0589
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Provider Business Mailing Address
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Address Line | 1022 PARK BLVD
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City | MASSAPEQUA PARK
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State | NY
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Zip | 11762-2784
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Country | US
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Telephone | 516-798-9444
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Fax | 516-798-0589
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | RAJENDRAPRASAD VENIGALLA
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Credential |
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Telephone | 347-528-8893
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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 |
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License Number State |
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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 | 007694
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License Number State | NY
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