Organization
167ST RX CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN BENNETT (SUPERVISING PHARMACIST)
(718) 681-5644
Entity
Organization
Contact information
Practice address
112 E 167TH ST, BRONX, NY 10452-8205
(718) 681-5644
(718) 588-5814
Mailing address
112 E 167TH ST, BRONX, NY 10452-8205
(718) 681-5644
(718) 588-5814
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21343
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00268575
—
NY
Enumeration date
11/11/2005
Last updated
01/28/2010
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