Organization
90-15 ROOSEVELT PHARMACY CORP
Active
Other names
MI FARMACIA
Organization subpart
No
Provider details
NPI number
Authorized official
ELENA LUNA RPH (PRESIDENT)
(718) 429-7666
Entity
Organization
Contact information
Practice address
9015 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-7938
(718) 429-7666
(718) 898-9505
Mailing address
9015 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-7938
(718) 429-7666
(718) 898-9505
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
024229
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922307
—
NY
01
—
2057679
PK
—
Enumeration date
08/31/2006
Last updated
09/19/2025
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