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General NPI Number Information
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NPI Number | 1891120945
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Entity Type | Organization
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Legal Business Name | PA HEALTH INC
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Dates
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Enumeration Date | 09/09/2013
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Last Update Date | 09/09/2013
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Provider Practice Location Address
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Address Line | 6626 METROPOLITAN AVE
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City | MIDDLE VILLAGE
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State | NY
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Zip | 11379-1630
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Country | US
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Telephone | 347-725-4842
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Fax |
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Provider Business Mailing Address
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Address Line | 6626 METROPOLITAN AVE
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City | MIDDLE VILLAGE
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State | NY
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Zip | 11379-1630
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST
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Name | DR. JENNIFER LYNN RABBIN
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Credential | PHARMD
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Telephone | 518-225-3297
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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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