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General NPI Number Information
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NPI Number | 1851160691
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Entity Type | Organization
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Legal Business Name | ROCKAWAY BEACH PHARMACY INC
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Dates
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Enumeration Date | 12/21/2023
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 10119 ROCKAWAY BEACH BLVD
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City | ROCKAWAY PARK
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State | NY
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Zip | 11694-2841
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Country | US
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Telephone | 718-233-8787
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Fax | 718-233-8788
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Provider Business Mailing Address
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Address Line | 7505 AVENUE X
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City | BROOKLYN
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State | NY
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Zip | 11234-6637
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Country | US
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Telephone | 347-207-8919
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Fax | 718-233-8788
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Authorized Official
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Title or Position | OWNER
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Name | MR. IGOR ABRAMOV
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Credential | PHARMD
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Telephone | 347-207-8919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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