Organization
GRAND STREET PHARMACEUTICAL LLC
Active
Other names
BUY-RITE PHARMACY IV
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY CEN LIU (MANAGING MEMBER)
(212) 625-9505
Entity
Organization
Contact information
Practice address
215-7 GRAND ST, NEW YORK, NY 10013
(212) 625-9505
(212) 625-9509
Mailing address
215-7 GRAND ST, NEW YORK, NY 10013
(212) 625-9505
(212) 625-9509
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
028030
NY
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02829894
—
NY
01
—
2068665
PK
—
Enumeration date
10/31/2006
Last updated
08/01/2023
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