Organization
139 PHARMACY, INC.
Active
Parent organization
139 PHARMACY, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
139 PHARMACY, INC.
Authorized official
MR. VINAY WALTER (RPH)
(212) 283-6623
Entity
Organization
Contact information
Practice address
3411 BROADWAY, NEW YORK, NY 10031-7407
(212) 283-5764
(212) 283-5764
Mailing address
3411 BROADWAY, NEW YORK, NY 10031-7407
(212) 283-5764
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
015978
NY
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01423894
—
NY
01
—
3337373
NABP
NY
Enumeration date
01/29/2007
Last updated
08/23/2023
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