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Organization

AC NORTHERN LLC

Active
Other names
AC NORTHERN PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
KI JULIA PARK RPH (PRESIDENT)
(718) 886-0060
Entity
Organization

Contact information

Practice address
15416 NORTHERN BLVD, FLUSHING, NY 11354-5030
(718) 886-0060
(718) 886-0061
Mailing address
15416 NORTHERN BLVD, FLUSHING, NY 11354-5030
(718) 886-0060
(718) 886-0061

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
027294
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02672773
NY
01
2064717
PK
Enumeration date
09/20/2006
Last updated
01/18/2017
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