Organization
PENN PHARMACY INC
Active
Other names
PENN PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
ALEKSANDR GULKAROV (PRESIDENT)
(718) 484-4280
Entity
Organization
Contact information
Practice address
1666 BOSTON RD, BRONX, NY 10460-4980
(718) 484-4280
(718) 484-4281
Mailing address
1666 BOSTON RD, BRONX, NY 10460
(718) 484-4280
(718) 484-4281
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
034987
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2163693
PK
—
Enumeration date
08/16/2016
Last updated
12/21/2016
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