Organization
ELMHURST STAR PHARMACY INC.
Active
Other names
CONCOURSE PHARMCY
Organization subpart
No
Provider details
NPI number
Authorized official
SATYA DASARI (PRESIDENT)
(718) 229-2200
Entity
Organization
Contact information
Practice address
1850 GRAND CONCOURSE, BRONX, NY 10457-5520
(718) 299-2200
(718) 299-6200
Mailing address
1850 GRAND CONCOURSE, BRONX, NY 10457-5520
(718) 299-2200
(718) 299-6900
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
029299
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03094066
—
NY
01
—
3360346
NCPDP
—
Enumeration date
03/10/2009
Last updated
12/17/2015
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