Organization
M.G.R. FARMACIA LATINA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAFAEL AUGUSTO RODRIGUEZ (PRESIDENT)
(718) 205-3633
Entity
Organization
Contact information
Practice address
3763 103RD ST, CORONA, NY 11368-1952
(718) 205-3633
(718) 205-5775
Mailing address
3763 103RD ST, CORONA, NY 11368-1952
(718) 205-3633
(718) 205-5775
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02511122
—
NY
01
—
3336383
NCPDP
NY
Enumeration date
09/20/2006
Last updated
08/22/2020
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