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Organization

DIVINO PHARMACY CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. NANCY FERNANDEZ (PRESIDENT)
(646) 251-2225
Entity
Organization

Contact information

Practice address
30 E KINGSBRIDGE RD, BRONX, NY 10468-7502
(718) 933-0278
(718) 933-0279
Mailing address
30 E KINGSBRIDGE RD, BRONX, NY 10468-7502

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
NY
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03325880
NY
Enumeration date
03/04/2011
Last updated
05/12/2022
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