# LA GRAN FARMACIA INC

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

## Provider details

- **NPI number:** 1528604428
- **Authorized official:** CARLOS JIMENEZ (OWNER)
- **Authorized official phone:** (718) 396-4091

## Contact information

- **Practice address:** 9110 37TH AVE, JACKSON HEIGHTS, NY 11372-7920
- **Practice address phone:** (718) 396-4091
- **Mailing address:** 9110 37TH AVE, JACKSON HEIGHTS, NY 11372-7920
- **Mailing address phone:** (718) 396-4091

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 11/26/2019
- **Last updated:** 03/19/2020