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Organization

PRO LIFE APOTHECARY CORP

Active
Other names
VITAHEALTH APOTHECARY
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID RESTEPO RPH (SECRETARY)
(212) 628-1110
Entity
Organization

Contact information

Practice address
1235 1ST AVE, NEW YORK, NY 10065-6311
(212) 628-1110
(212) 628-1117
Mailing address
1235 1ST AVE, NEW YORK, NY 10065-6311
(212) 628-1110
(212) 628-1117

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
027558
NY
3336C0004X
Compounding Pharmacy
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02779573
NY
01
2068111
PK
Enumeration date
08/18/2006
Last updated
02/05/2016
About Stedi
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  • EDI platform