Organization
EDELSIE PHARMACY INC
Active
Other names
Edelsie Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
EDRIS VINCENT (RPH SUPERVISING PHARMACIST)
(917) 216-2630
Entity
Organization
Contact information
Practice address
11228 FRANCIS LEWIS BLVD, QUEENS VILLAGE, NY 11429-2224
(718) 736-0036
(718) 736-0034
Mailing address
11228 FRANCIS LEWIS BLVD, QUEENS VILLAGE, NY 11429-2224
(718) 736-0036
(718) 736-0034
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
032282
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2142910
PK
—
Enumeration date
11/15/2013
Last updated
11/15/2013
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