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Organization

5TH AVE DRUG, INC

Active
Other names
SALU-MED
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TOMAS DIAZ RPH (PRESIDENT)
(631) 231-4960
Entity
Organization

Contact information

Practice address
1805 5TH AVE, SUITE B, BAY SHORE, NY 11706-1761
(631) 231-4960
(631) 231-0368
Mailing address
1805 B FIFTH AVE., BAY SHORE, NY 11706
(631) 231-4960
(631) 231-0368

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
NY
333600000X
Pharmacy
020130
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01125584
NY
01
3394020
NAPB
Enumeration date
10/12/2005
Last updated
09/11/2025
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