Organization
GSV PHARMACY INC
Active
Other names
lane drugs
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM YANKOVICH (SUPERVISING PHARMACIST)
(718) 435-1118
Entity
Organization
Contact information
Practice address
4623 13TH AVE, BROOKLYN, NY 11219-2631
(718) 435-1118
(718) 435-4908
Mailing address
4623 13TH AVE, BROOKLYN, NY 11219-2631
(718) 435-1118
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
028914
NY
3336C0003X
Community/Retail Pharmacy
Primary
028914
NY
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028914
STATE LICENSE
NY
Enumeration date
01/09/2007
Last updated
07/09/2020
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