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General NPI Number Information
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NPI Number | 1962629048
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Entity Type | Organization
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Legal Business Name | ETHAN DRUG CORP
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 10/31/2007
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Provider Practice Location Address
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Address Line | 27268 GRAND CENTRAL PKWY
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City | FLORAL PARK
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State | NY
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Zip | 11005-1342
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Country | US
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Telephone | 718-631-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 27268 GRAND CENTRAL PKWY
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City | FLORAL PARK
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State | NY
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Zip | 11005-1342
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Country | US
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Telephone | 718-631-9300
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Fax | 718-747-3271
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Authorized Official
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Title or Position | OWNER
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Name | DANNY ASKARI
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Credential | RPH
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Telephone | 718-631-9300
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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 | 028336
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License Number State | NY
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