Organization
KM PHARMACY LLC
Active
Other names
KM Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY LEE (SUPERVISING PHARMACIST)
(718) 888-0110
Entity
Organization
Contact information
Practice address
4135 KISSENA BLVD, FLUSHING, NY 11355-3127
(718) 888-0110
(718) 888-0093
Mailing address
4135 KISSENA BLVD, FLUSHING, NY 11355-3127
(718) 888-0110
(718) 888-0093
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
034105
NY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2155808
PK
—
Enumeration date
12/07/2015
Last updated
03/30/2017
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