Organization
CSE DRUG CORP
Active
Other names
SANTIAGO PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN POVEDA (PRESIDENT)
(929) 254-9946
Entity
Organization
Contact information
Practice address
4043 JUNCTION BLVD, CORONA, NY 11368-2121
(718) 205-7900
(718) 205-7908
Mailing address
4043 JUNCTION BLVD, CORONA, NY 11368-2121
(718) 205-7900
(718) 205-7908
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
035435
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05006551
—
NY
Enumeration date
05/12/2017
Last updated
06/23/2022
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