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Organization

WALGREENS PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MUNTASIR AZMI PHARMD (PHARMACIST)
(347) 285-6466
Entity
Organization

Contact information

Practice address
1333 E PUTNAM AVE, RIVERSIDE, CT 06878-1529
(347) 285-6466
Mailing address
16010 89TH AVE, 4K, JAMAICA, NY 11432-3944
(347) 285-6466

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
28RI03612000
NJ
183500000X
Pharmacist
Primary
PCT.0012856
CT

Other

Enumeration date
12/29/2013
Last updated
12/29/2013
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