Organization
2027 ALICO PHARMACY CORP
Active
Other names
ALICO PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY RODRIGUEZ (SECRETARY)
(718) 294-1949
Entity
Organization
Contact information
Practice address
2027 JEROME AVE, BRONX, NY 10453-1803
(718) 294-1949
(718) 294-5993
Mailing address
2027 JEROME AVE, BRONX, NY 10453-1803
(718) 294-1949
(718) 294-5993
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
028927
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2059423
PK
—
05
—
2961700
—
NY
Enumeration date
05/17/2007
Last updated
04/09/2015
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