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Organization
DRUGTOWN
Active
Organization
DRUGTOWN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD ALLEN CLEMENTS (PHARMACIST)
(718) 381-3014
Entity
Organization
Contact information
Practice address
6416 MYRTLE AVE, GLENDALE, NY 11385-6216
(718) 381-3014
Mailing address
64-16 MYRTLE AVENUE, GLENDALE, NY 11385
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
16843
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00486517
—
NY
Enumeration date
03/31/2010
Last updated
03/31/2010
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