Organization
H PLAZA PHARMACY INC
Active
Other names
Moduna Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHIN LEE (PRESIDENT)
(917) 656-0206
Entity
Organization
Contact information
Practice address
253-34 NORTHERN BLVD., LITTLE NECK, NY 11362-1414
(516) 441-5400
(516) 441-5402
Mailing address
25334 NORTHERN BLVD, LITTLE NECK, NY 11362-1414
(516) 441-5400
(516) 441-5402
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
030794
NY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2131962
PK
—
05
—
RZ50057B
—
NY
Enumeration date
10/04/2011
Last updated
01/30/2019
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