Organization
LIVING WELL PHARMACY INC
Active
Other names
Living Well Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE KANE-LIPARI RPH (SUPERVISING PHARMACIST)
(718) 477-5483
Entity
Organization
Contact information
Practice address
3555 VICTORY BLVD, STATEN ISLAND, NY 10314-6764
(718) 477-5483
(718) 477-5480
Mailing address
3555 VICTORY BLVD, STATEN ISLAND, NY 10314-6764
(718) 477-5483
(718) 477-5480
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
031311
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03749213
—
NY
01
—
2136438
PK
—
Enumeration date
08/11/2012
Last updated
04/26/2016
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