Organization
AVE O PHARMACY CORP
Active
Other names
AVE O PHARMACY CORP
Organization subpart
No
Provider details
NPI number
Authorized official
LIYA RAFAILOV (PRESIDENT)
(718) 232-3500
Entity
Organization
Contact information
Practice address
68 AVENUE O, BROOKLYN, NY 11204-6472
(718) 232-3500
(718) 232-0077
Mailing address
68 AVENUE O, BROOKLYN, NY 11204-6472
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
026338
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02495476
—
NY
01
—
3335216
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/12/2006
Last updated
01/26/2009
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