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General NPI Number Information
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NPI Number | 1932106366
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Entity Type | Organization
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Legal Business Name | THRIFTWAY FOSTER AVE. DRUG CORP
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 1717 FOSTER AVE
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City | BROOKLYN
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State | NY
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Zip | 11230-1809
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Country | US
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Telephone | 718-724-1717
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Fax | 718-859-4688
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Provider Business Mailing Address
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Address Line | 1717 FOSTER AVE
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City | BROOKLYN
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State | NY
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Zip | 11230-1809
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Country | US
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Telephone | 718-724-1717
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Fax | 718-859-4688
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Authorized Official
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Title or Position | CORP. SECY
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Name | MR. ALEX PERCHUK
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Credential | RPH
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Telephone | 718-835-2000
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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 | 027122
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License Number State | NY
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