Organization
MEDILANE PHARMACY CORP
Active
Other names
MEDILANE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIAM FUNG (SECRETARY)
(212) 571-2888
Entity
Organization
Contact information
Practice address
204 CLINTON ST, NEW YORK, NY 10002-7576
(212) 571-2888
(212) 571-6881
Mailing address
204 CLINTON ST, NEW YORK, NY 10002-7576
(212) 571-2888
(212) 571-6881
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
023258
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01741868
—
NY
01
—
2063673
PK
—
Enumeration date
08/31/2006
Last updated
09/18/2013
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