Organization
THRIFTWAY 10TH AVE DRUG CORP
Active
Other names
Thriftway Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEX PERCHUK RPH (CORP. SECY)
(718) 835-2000
Entity
Organization
Contact information
Practice address
646 10TH AVE, NEW YORK, NY 10036-2929
(212) 956-1100
(212) 956-1175
Mailing address
646 10TH AVE, NEW YORK, NY 10036-2929
(212) 956-1100
(212) 956-1175
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
028807
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028807
LICENSE NUMBER
NY
05
—
02967417
—
NY
Enumeration date
04/09/2008
Last updated
07/24/2013
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