Organization
LACONIA AVENUE PHARMACY CORP
Active
Other names
Laconia Avenue Pharmacy Corp
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL ANOKYE (SUPERVISING PHARMACIST)
(917) 332-8533
Entity
Organization
Contact information
Practice address
4041 LACONIA AVE, BRONX, NY 10466-4917
(347) 843-7747
(347) 843-7748
Mailing address
4041 LACONIA AVE, BRONX, NY 10466-4917
(347) 843-7747
(347) 843-7748
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168990
PK
—
Enumeration date
04/19/2017
Last updated
05/04/2017
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