Organization
32-24 DRUG CORP
Active
Other names
Athenas Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MIKHAIL BORUKHOV (PRESIDENT)
(718) 204-7867
Entity
Organization
Contact information
Practice address
3284 STEINWAY ST, ASTORIA, NY 11103-4006
(718) 204-7867
(718) 204-5936
Mailing address
3284 STEINWAY ST, ASTORIA, NY 11103-4006
(718) 204-7867
(718) 204-5936
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
031325
NY
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2135862
PK
—
Enumeration date
03/13/2012
Last updated
02/06/2019
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