Organization
LIFE STAR PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE SOLANO (PRESIDENT)
(718) 684-5010
Entity
Organization
Contact information
Practice address
1215 JEROME AVE, BRONX, NY 10452-3301
(718) 684-5010
(646) 217-3682
Mailing address
1215 JEROME AVE, BRONX, NY 10452-3301
(718) 684-5010
(718) 684-1011
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05737628
—
NY
Enumeration date
11/16/2017
Last updated
04/01/2021
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