Organization
EYE OF HORUS PHARMACEUTICAL SERVICES,LLC
Active
Other names
Able Care Pharmacy and Medical Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
ASHRAF MOUSTAFA PHARM D (PRESIDENT)
(818) 519-6255
Entity
Organization
Contact information
Practice address
15 PALOMBA DR, ENFIELD, CT 06082-3888
(860) 745-0183
(860) 741-6503
Mailing address
15 PALOMBA DR, ENFIELD, CT 06082-3888
(860) 745-0183
(860) 741-6503
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PCY0001177
CT
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008061223
—
CT
01
—
2152674
PK
—
Enumeration date
03/26/2015
Last updated
07/19/2018
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