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Organization
WILLIS AVE DRUGS INC
Active
Organization
WILLIS AVE DRUGS INC
Active
Other names
Willis Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SAMINA NADEEM (PRESIDENT)
(718) 585-5300
Entity
Organization
Contact information
Practice address
208 WILLIS AVE, BRONX, NY 10454-4844
(718) 585-5300
(718) 585-1213
Mailing address
208 WILLIS AVE, BRONX, NY 10454-4844
(718) 585-5300
(718) 585-1213
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
035797
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04889089
—
NY
01
—
2171836
PK
—
Enumeration date
09/29/2017
Last updated
04/19/2018
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