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Organization
VITAL MED LLC.
Active
Organization
VITAL MED LLC.
Active
Other names
VITAL MED PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KHANIMOV (PRESIDENT)
(718) 544-0700
Entity
Organization
Contact information
Practice address
6942 MAIN ST, FLUSHING, NY 11367-1723
(718) 544-0700
(718) 544-0703
Mailing address
6942 MAIN ST, FLUSHING, NY 11367-1723
(718) 544-0700
(718) 544-0703
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05013718
—
NY
Enumeration date
05/07/2015
Last updated
11/14/2025
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