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Organization
GLENRIDGE PHARMACY LLC
Active
Organization
GLENRIDGE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL CAPUSANO (OWNER)
(347) 865-1269
Entity
Organization
Contact information
Practice address
6801 MYRTLE AVE, GLENDALE, NY 11385-7267
(718) 366-3561
Mailing address
7755 66TH RD, MIDDLE VILLAGE, NY 11379-2231
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
NULL
Other
Enumeration date
06/05/2017
Last updated
06/05/2017
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