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Organization
VISAI LAVEN PHARMACY INC
Active
Organization
VISAI LAVEN PHARMACY INC
Active
Other names
WOODSIDE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SUBBAROW SANNIDHI (PRESIDENT)
(718) 205-0550
Entity
Organization
Contact information
Practice address
49 02 QUEENS BLVD, WOODSIDE, NY 11377
(718) 205-0550
(718) 205-0551
Mailing address
49 02 QUEENS BLVD, WOODSIDE, NY 11377
(718) 205-0550
(718) 205-0551
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
029808
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3357488
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/05/2008
Last updated
03/15/2010
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