Organization
870 SOUTHERN DRUG CORP.
Active
Other names
Kingsboro Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH P POHL III (PRESIDENT & CEO)
(724) 779-4720
Entity
Organization
Contact information
Practice address
924 MYRTLE AVENUE, BROOKLYN, NY 11206-7295
(718) 443-6000
(718) 874-3638
Mailing address
40 PENNWOOD PLACE, SUITE 300, WARRENDALE, PA 15086-6526
(724) 779-4720
(724) 779-4721
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
029877
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2123798
PK
—
05
—
3158481
—
NY
Enumeration date
10/13/2006
Last updated
05/04/2020
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