Organization
18TH AVE PHARMACY CORP
Active
Other names
18TH AVE PHARMACY CORP
Organization subpart
No
Provider details
NPI number
Authorized official
GRIGORY BEYLIK (PRESIDENT)
(718) 331-3600
Entity
Organization
Contact information
Practice address
5411 18TH AVE, BROOKLYN, NY 11204-1928
(718) 331-3600
(718) 331-3099
Mailing address
5411 18TH AVE, BROOKLYN, NY 11204-1928
(718) 331-3600
(718) 331-3099
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
025629
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02376772
—
NY
01
—
2058804
PK
—
Enumeration date
08/18/2006
Last updated
11/25/2014
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