Organization
CANAL STREET PHARMACY INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HEI (TRISTAN) LIU (CORP. OFFICER)
(212) 748-4900
Entity
Organization
Contact information
Practice address
2029 86TH ST., GROUND FLOOR, BROOKLYN, NY 11214
(212) 748-4900
Mailing address
2029 86TH ST., GROUND FLOOR, BROOKLYN, NY 11214
(212) 748-4900
(212) 748-4902
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
028411
NY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02892895
—
NY
Enumeration date
06/13/2007
Last updated
10/31/2022
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