Organization
EBI PHARMACY & SUPERMARKET INC
Active
Other names
EBI PHARMACY & SUPERMARKET INC.
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES IGBODO (PRESIDENT)
(718) 217-7700
Entity
Organization
Contact information
Practice address
21620 HILLSIDE AVE, QUEENS VILLAGE, NY 11427-1947
(718) 217-7700
(718) 217-6861
Mailing address
21620 HILLSIDE AVE, QUEENS VILLAGE, NY 11427-1947
(718) 217-7700
(718) 217-6861
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
030373
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5801370
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/22/2010
Last updated
11/24/2010
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