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General NPI Number Information
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NPI Number | 1912945569
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Entity Type | Organization
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Legal Business Name | LA RUCHE PHARMACY,INC
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 02/01/2008
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Provider Practice Location Address
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Address Line | 494 ROCKAWAY PKWY
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City | BROOKLYN
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State | NY
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Zip | 11212-3248
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Country | US
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Telephone | 718-485-6923
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Fax | 718-922-3287
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Provider Business Mailing Address
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Address Line | 494 ROCKAWAY PKWY
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City | BROOKLYN
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State | NY
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Zip | 11212-3248
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Country | US
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Telephone | 718-485-6923
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Fax | 718-922-3287
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUNIL B PATEL
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Credential |
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Telephone | 718-485-6923
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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 | 019596
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License Number State | NY
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