Organization
ELMWAY II PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRISTAN LIU (CORP. OFFICER)
(718) 699-1882
Entity
Organization
Contact information
Practice address
8607 51ST AVE, ELMHURST, NY 11373-3922
(718) 699-1882
Mailing address
8607 51ST AVE, ELMHURST, NY 11373-3922
(718) 699-1882
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
033562
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0033562
NYS BOARD OF PHARMACY
NY
Enumeration date
05/21/2015
Last updated
05/21/2015
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