Organization
LONGEVITY PHARMACY LLC
Active
Other names
FUZHOU PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROMOND FUNG (MEMBER)
(212) 693-8866
Entity
Organization
Contact information
Practice address
96 E BROADWAY, NEW YORK, NY 10002-7031
(212) 693-8866
(815) 425-8920
Mailing address
96 E BROADWAY, NEW YORK, NY 10002-7031
(212) 693-8866
(815) 425-8920
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
028788
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2063778
PK
—
05
—
2949604
—
NY
Enumeration date
02/27/2007
Last updated
03/30/2016
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