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Organization
MERCEDES PHARMACY CORP
Active
Organization
MERCEDES PHARMACY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA JOHNSON (VICE PRESIDENT)
(718) 292-7979
Entity
Organization
Contact information
Practice address
514 WILLIS AVE, BRONX, NY 10455-4028
(718) 292-7979
(718) 701-0974
Mailing address
514 WILLIS AVE, BRONX, NY 10455-4028
(718) 292-7979
(718) 701-0974
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
037320
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02707546
—
NY
Enumeration date
04/12/2007
Last updated
08/12/2011
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