Organization
GREENWICH PHARMACY LLC
Active
Other names
Greenwich Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DMITRI DANAIROV (OWNER)
(203) 661-2721
Entity
Organization
Contact information
Practice address
116 GREENWICH AVE, GREENWICH, CT 06830-5504
(203) 661-2721
Mailing address
11045 68TH AVE, FOREST HILLS, NY 11375-2936
(917) 559-3632
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0722048
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/30/2010
Last updated
08/04/2010
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