Organization
RAINDEW FAMILY CENTER LTD
Active
Other names
RAINDEW PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW KOGUT RPH (PHARMACIST)
(718) 539-7752
Entity
Organization
Contact information
Practice address
35 15 FRANCIS LEWIS BLVD, BAYSIDE, NY 11358-1990
(718) 539-7752
(718) 445-8250
Mailing address
35 15 FRANCIS LEWIS BLVD, BAYSIDE, NY 11358-1990
(718) 539-7752
(718) 445-8250
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
018669
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00900638
—
NY
01
—
2062429
PK
—
Enumeration date
12/18/2006
Last updated
05/09/2016
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