Organization
MAKARIOUS HEALTH CORP
Active
Other names
Live Well Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN MOUSSA PHARM.D (OWNER)
(917) 544-8056
Entity
Organization
Contact information
Practice address
1722 UTICA AVE STE 2, BROOKLYN, NY 11234-2121
(718) 968-1600
(718) 968-1602
Mailing address
1722 UTICA AVE STE 2, BROOKLYN, NY 11234-2121
(718) 968-1600
(718) 968-1602
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05171751
—
NY
Enumeration date
08/19/2017
Last updated
08/10/2020
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