Organization
ASENCIO PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID ASENCIO RPH (SUPERVISING PHARMACIST)
(718) 299-2416
Entity
Organization
Contact information
Practice address
154 E 174TH ST, BRONX, NY 10457-6904
(718) 299-2416
(718) 299-5176
Mailing address
154 E 174TH ST, BRONX, NY 10457-6904
(718) 299-2416
(718) 299-5176
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
020822
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01215127
—
NY
Enumeration date
09/21/2005
Last updated
02/13/2008
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