Organization
ST THERESA PHARMACY CORP
Active
Other names
ST TERESA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY OVALLES (PRESIDENT)
(646) 413-5795
Entity
Organization
Contact information
Practice address
3849 10TH AVENUE, NEW YORK, NY 10034
(646) 413-5795
Mailing address
160 BUSH ST APT 4F, BRONX, NY 10453-4306
(646) 413-5795
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
09/14/2011
Last updated
10/15/2011
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