Organization
RIVERDALE HEALTHY LIFE INC
Active
Other names
Tri-Road Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL HADDAD (OWNER)
(917) 570-5169
Entity
Organization
Contact information
Practice address
791 WESTCHESTER AVE, BRONX, NY 10455-1722
(917) 570-5169
(718) 483-9522
Mailing address
791 WESTCHESTER AVE, BRONX, NY 10455-1722
(718) 618-7692
(718) 483-9522
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
034827
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167019
PK
—
Enumeration date
01/10/2017
Last updated
03/13/2017
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