Organization
LIBERTY DRUG INC
Active
Other names
POLLINA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS DELLORUSSO (OWNER)
(718) 331-4300
Entity
Organization
Contact information
Practice address
7605 13TH AVE, BROOKLYN, NY 11228-2411
(718) 331-4300
Mailing address
7605 13TH AVE, BROOKLYN, NY 11228-2411
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
026987
NY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02616622
—
NY
01
—
3341182
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
01/30/2007
Last updated
12/28/2019
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