Organization
LITTLE GELT PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH EVANS R.PH. (SUPERVISING PHARMACIST)
(718) 671-6410
Entity
Organization
Contact information
Practice address
111 DREISER LOOP, BRONX, NY 10475-2701
(718) 671-6410
Mailing address
111 DREISER LOOP, BRONX, NY 10475-2701
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01357446
—
NY
Enumeration date
02/21/2007
Last updated
08/22/2020
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