Organization
ARLO DRUG STORE OF L I INC
Active
Other names
ARLO DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
RAJENDRAPRASAD VENIGALLA (OWNER/PRESIDENT)
(347) 528-8893
Entity
Organization
Contact information
Practice address
1022 PARK BLVD, MASSAPEQUA PARK, NY 11762-2784
(516) 798-9444
(516) 798-0589
Mailing address
1022 PARK BLVD, MASSAPEQUA PARK, NY 11762-2784
(516) 798-9444
(516) 798-0589
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
007694
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2059244
PK
—
05
—
380570
—
NY
Enumeration date
06/19/2006
Last updated
03/03/2020
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