Organization
ROOSEVELT DRUG CORP
Active
Other names
Roosevelt Drugs and Surgicals
Organization subpart
No
Provider details
NPI number
Authorized official
SHUJAAT MIR (PRESIDENT)
(718) 424-1291
Entity
Organization
Contact information
Practice address
74 19 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-6529
(718) 424-1291
(718) 898-1860
Mailing address
74 19 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-6529
(718) 424-1291
(718) 898-1860
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
035080
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2166657
PK
—
Enumeration date
08/10/2016
Last updated
03/31/2017
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