Organization
1400 ST NICHOLAS LLC
Active
Other names
SAFE HEART PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA FAVALE (SUPERVISING PHARMACIST)
(212) 568-5454
Entity
Organization
Contact information
Practice address
1400 SAINT NICHOLAS AVE, NEW YORK, NY 10033-4027
(212) 568-5454
(212) 568-5340
Mailing address
1400 SAINT NICHOLAS AVE, NEW YORK, NY 10033-4027
(212) 568-5454
(212) 568-5340
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2177835
PK
—
Enumeration date
05/21/2018
Last updated
12/18/2023
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