Organization
LOUIS PHARMACY INC.
Active
Other names
CITY LINE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOBY NELLICKEL (PRESIDENT, PIC)
(718) 324-0555
Entity
Organization
Contact information
Practice address
4704 WHITE PLAINS RD, BRONX, NY 10470-1103
(718) 324-0555
(718) 324-4574
Mailing address
4704 WHITE PLAINS RD, BRONX, NY 10470-1103
(718) 324-0555
(718) 324-4574
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
026513
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02501164
—
NY
01
—
3371426
NCPDP
NY
Enumeration date
11/16/2006
Last updated
05/07/2018
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