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General NPI Number Information
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NPI Number | 1952640088
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Entity Type | Organization
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Legal Business Name | WAKEFIELD DRUGS INC
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Dates
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Enumeration Date | 02/08/2013
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 4334A WHITE PLAINS RD
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City | BRONX
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State | NY
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Zip | 10466-3098
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Country | US
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Telephone | 718-547-0040
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Fax | 718-547-0046
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Provider Business Mailing Address
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Address Line | 4334A WHITE PLAINS RD
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City | BRONX
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State | NY
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Zip | 10466-3098
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Country | US
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Telephone | 718-547-0040
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Fax | 718-547-0046
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Authorized Official
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Title or Position | SP PHARMACIST
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Name | MR. GOGI GEORGE
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Credential | RPH
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Telephone | 201-341-5756
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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 | 031633
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License Number State | NY
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