Organization
AUSTRA LINE PHARMACY INC.
Active
Other names
AUSTRA LINE PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
CHINEDU AGBASIONWE RPH (PRESIDENT)
(718) 531-6000
Entity
Organization
Contact information
Practice address
5916 GLENWOOD RD, BROOKLYN, NY 11234-1817
(718) 531-6000
(718) 531-6004
Mailing address
5916 GLENWOOD RD, BROOKLYN, NY 11234-1817
(718) 531-6000
(718) 531-6004
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
027830
NY
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2068227
PK
—
05
—
2858006
—
NY
Enumeration date
08/18/2006
Last updated
02/20/2017
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