Organization
108 PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROMAN BADALOV (OWNER)
(646) 752-0490
Entity
Organization
Contact information
Practice address
4502 108TH ST, CORONA, NY 11368-2917
(718) 847-1982
(718) 228-4985
Mailing address
4502 108TH ST, CORONA, NY 11368-2917
(718) 847-1982
(718) 228-4985
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
01/04/2024
Last updated
01/04/2024
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