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Organization
TMC191LLC
Active
Organization
TMC191LLC
Active
Other names
The Modern Chemist Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PARTHIV VORA (SUPERVISING PHARMACIST)
(508) 287-8432
Entity
Organization
Contact information
Practice address
191 4TH AVE, BROOKLYN, NY 11217-3124
(347) 599-0174
(347) 599-0201
Mailing address
191 4TH AVE, BROOKLYN, NY 11217-3124
(347) 599-0174
(347) 599-0201
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
032404
NY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144595
PK
—
Enumeration date
03/04/2014
Last updated
04/16/2014
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