Organization
LIC PHARMACY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONG TIAN YU RPH (PRESIDENT)
(347) 242-2981
Entity
Organization
Contact information
Practice address
4035 21ST ST STE 4C, LONG ISLAND CITY, NY 11101-6140
(347) 242-2981
(347) 242-2619
Mailing address
4035 21ST ST STE 4C, LONG ISLAND CITY, NY 11101-6140
(347) 242-2981
(347) 242-2619
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
11/10/2021
Last updated
11/10/2021
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