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Organization

SOS PHARMACY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SHUSHANA SEMENOV (PRESIDENT)
(917) 933-4000
Entity
Organization

Contact information

Practice address
1201 AVENUE Z, BROOKLYN, NY 11235-4301
(917) 933-4000
(917) 933-4004
Mailing address
1201 AVENUE Z, BROOKLYN, NY 11235-4301
(917) 933-4000
(917) 933-4004

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
032055
NY STATE LICENSE
NY
05
03633823
NY
01
5808211
NCPDP
NY
01
6979960001
MEDICARE NSC
NY
Enumeration date
05/08/2013
Last updated
02/17/2014
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