Organization
FULL CARE PHARMACY INC
Active
Other names
Community Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ROLSON CHENNAMKARA ABRAHAM BS PHARM (PRESIDENT)
(718) 372-5300
Entity
Organization
Contact information
Practice address
2913 SURF AVE, BROOKLYN, NY 11224-1705
(718) 372-5300
(718) 372-2451
Mailing address
2913 SURF AVE, BROOKLYN, NY 11224-1705
(718) 372-5300
(718) 372-2451
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
031020
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03368458
—
NY
01
—
2133603
PK
—
Enumeration date
08/30/2011
Last updated
12/10/2021
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