# AGUSTIN PHARMACY INC

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

## Provider details

- **NPI number:** 1467574970
- **Authorized official:** MR. FRANK CAPPELLO RPH (SUPERVISING PHARMACIST)
- **Authorized official phone:** (718) 937-8160

## Contact information

- **Practice address:** 3920 29TH ST, LONG ISLAND CITY, NY 11101-3708
- **Practice address phone:** (718) 937-8160
- **Practice address fax:** (718) 937-8154
- **Mailing address:** 3920 29TH ST, LONG ISLAND CITY, NY 11101-3708
- **Mailing address phone:** (718) 937-8160
- **Mailing address fax:** (718) 937-8154

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 028110 | NY | Yes |

## Other

- **Enumeration date:** 04/04/2007
- **Last updated:** 07/23/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02966778 | — | NY |