Organization
GREEN FOREST MARKET INC.
Active
Other names
GREEN FOREST PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
VITALIY CHERTKOV (PRESIDENT)
(929) 333-9669
Entity
Organization
Contact information
Practice address
1520 AVENUE M, BROOKLYN, NY 11230-5267
(929) 333-9669
(929) 333-9667
Mailing address
1520 AVENUE M, BROOKLYN, NY 11230-5267
(929) 333-9669
(929) 333-9667
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
032321
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03821950
—
NY
Enumeration date
11/26/2013
Last updated
08/06/2014
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