Organization
LIFE INFUSION PHARMACY CORP
Active
Other names
Life Infusions
Organization subpart
No
Provider details
NPI number
Authorized official
ELAN GUTTMAN (OWNER)
(917) 575-2231
Entity
Organization
Contact information
Practice address
672 UTICA AVE, BROOKLYN, NY 11203-2210
(718) 981-9819
(718) 981-9356
Mailing address
4301 14TH AVE, BROOKLYN, NY 11219-1429
(718) 438-1421
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
036033
NY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2176518
PK
—
Enumeration date
04/12/2018
Last updated
04/30/2018
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