Organization
MOTT HAVEN PHARMACY INC
Active
Other names
motthaven pharmacy & surgical
Organization subpart
No
Provider details
NPI number
Authorized official
AMIT PATEL (PRESIDENT)
(718) 292-9144
Entity
Organization
Contact information
Practice address
400 E 141ST ST, BRONX, NY 10454-2212
(718) 292-9144
(718) 292-9145
Mailing address
400 E 141ST ST, BRONX, NY 10454-2212
(718) 292-9144
(718) 292-9145
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
032644
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2145709
PK
—
Enumeration date
10/16/2013
Last updated
03/26/2015
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