# ROOSEVELT CITY PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** City Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669913992
- **Authorized official:** HAIYING LI (PRESIDENT)
- **Authorized official phone:** (718) 255-1065

## Contact information

- **Practice address:** 7918 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-6717
- **Practice address phone:** (718) 255-1065
- **Practice address fax:** (718) 255-6734
- **Mailing address:** 7918 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-6717
- **Mailing address phone:** (718) 255-1065
- **Mailing address fax:** (718) 255-6734

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 035296 | NY | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | — | — |

## Other

- **Enumeration date:** 03/20/2017
- **Last updated:** 04/26/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2168619 | PK | — |