Organization
LAVIDA PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TING CHEN LEE (SUPERVISING PHARMACIST)
(718) 426-2525
Entity
Organization
Contact information
Practice address
4034 82ND ST, ELMHURST, NY 11373-1305
(718) 426-2525
(718) 426-2523
Mailing address
4034 82ND ST, ELMHURST, NY 11373-1305
(718) 426-2525
(718) 426-2523
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
026192
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02422879
—
NY
Enumeration date
03/31/2006
Last updated
07/16/2013
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