Organization
MBG PHARMACY CORP
Active
Other names
IMAGE PRESCIRPTION CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MAKSIM GLEZER RPH (PRES)
(917) 597-7759
Entity
Organization
Contact information
Practice address
119 CHURCH AVE, BROOKLYN, NY 11218-3917
(718) 686-7343
(718) 626-7492
Mailing address
119 CHURCH AVE, BROOKLYN, NY 11218-3917
(718) 686-7343
(718) 686-7492
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
025600
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02368656
—
NY
01
—
2064959
PK
—
Enumeration date
04/19/2007
Last updated
06/08/2016
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