Organization
OTC GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AELLA SHABUNEUSKAYA (PRODUCT MANAGER)
(516) 448-9089
Entity
Organization
Contact information
Practice address
2792 OCEAN AVE UNIT 5, BROOKLYN, NY 11229-4730
(516) 448-9089
Mailing address
2792 OCEAN AVE UNIT 5, BROOKLYN, NY 11229-4730
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
Primary
—
—
Other
Enumeration date
09/29/2020
Last updated
09/29/2020
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