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Organization

ESCRIPT360 QUEENS LLC

Active
Other names
eScript360
Organization subpart
No

Provider details

NPI number
Authorized official
YURIY DAVYDOV (MEMBER)
(646) 633-2170
Entity
Organization

Contact information

Practice address
6619 FRESH POND RD, RIDGEWOOD, NY 11385-3310
(718) 456-6667
(718) 456-6668
Mailing address
5 PENNY POND CT, GREENVALE, NY 11548-1400
(646) 633-2170

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
040896
PHARMACY LICENSE
NY
Enumeration date
03/04/2024
Last updated
05/02/2024
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