Organization
SHREEMAN PHARMACY INC
Active
Other names
GENOME PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LAVANYA AKULA RPH (OWNER/PRESIDENT/PIC/AO)
(516) 775-7775
Entity
Organization
Contact information
Practice address
1105 JERICHO TPKE, NEW HYDE PARK, NY 11040-4603
(516) 775-7775
(516) 775-7773
Mailing address
1105 JERICHO TPKE, NEW HYDE PARK, NY 11040-4603
(516) 775-7775
(516) 775-7773
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
035893
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2174301
PK
—
Enumeration date
11/22/2017
Last updated
01/24/2018
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