Organization
GLEN HEAD PHARMACY INC
Active
Other names
GLEN HEAD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICKY VOHORA DO (PRESIDENT)
(516) 934-0095
Entity
Organization
Contact information
Practice address
699 GLEN COVE AVE, GLEN HEAD, NY 11545-1602
(516) 676-1004
(516) 676-5407
Mailing address
699 GLEN COVE AVE, GLEN HEAD, NY 11545-1602
(516) 676-1004
(516) 676-5407
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00991084
—
NY
01
—
2064429
PK
—
Enumeration date
10/25/2006
Last updated
06/24/2022
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