# LAVIDA PHARMACY INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013978865
- **Authorized official:** TING CHEN LEE (SUPERVISING PHARMACIST)
- **Authorized official phone:** (718) 426-2525

## Contact information

- **Practice address:** 4034 82ND ST, ELMHURST, NY 11373-1305
- **Practice address phone:** (718) 426-2525
- **Practice address fax:** (718) 426-2523
- **Mailing address:** 4034 82ND ST, ELMHURST, NY 11373-1305
- **Mailing address phone:** (718) 426-2525
- **Mailing address fax:** (718) 426-2523

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 026192 | NY | Yes |

## Other

- **Enumeration date:** 03/31/2006
- **Last updated:** 07/16/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02422879 | — | NY |