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Organization
TRIBORO PHARMACY
Active
Organization
TRIBORO PHARMACY
Active
Other names
Triboro Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ATHANASATOS RPH (OWNER/SUPERVISING PHARMACIST)
(917) 865-7754
Entity
Organization
Contact information
Practice address
3720 DITMARS BLVD, ASTORIA, NY 11105-1841
(718) 777-7033
(718) 777-7038
Mailing address
3720 DITMARS BLVD, ASTORIA, NY 11105-1841
(718) 777-7033
(718) 777-7038
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
031263
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03455465
—
NY
01
—
2134928
PK
—
Enumeration date
03/12/2012
Last updated
04/20/2016
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