Organization
GRANDBROOK PHARMACY INC
Active
Other names
Grandbrook Pharmacy, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
GHULAM MURTAZA (PRESIDENT/SUP.PHARMACIST)
(718) 484-8690
Entity
Organization
Contact information
Practice address
642 SUTTER AVE, BROOKLYN, NY 11207-4113
(718) 484-8690
(347) 533-8629
Mailing address
182 LODGE AVE, HUNTINGTON STATION, NY 11746-2830
(718) 484-8690
(347) 533-8629
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
030640
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130653
PK
—
05
—
3344507
—
NY
Enumeration date
06/07/2011
Last updated
04/19/2017
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