Organization
115 IRVING AVE PHARMACY INC
Active
Other names
ATLANTIC PHARMACY & SURGICAL SUPPLIES
Organization subpart
No
Provider details
NPI number
Authorized official
DEVANG RAVAL (PHARMACY MANAGER)
(718) 484-2260
Entity
Organization
Contact information
Practice address
1706B ATLANTIC AVE, BROOKLYN, NY 11213-1206
(718) 484-2260
(718) 484-2261
Mailing address
1706B ATLANTIC AVE, BROOKLYN, NY 11213-1206
(718) 484-2260
(718) 484-2261
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
035113
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00833192
—
NY
01
—
2062245
PK
—
Enumeration date
12/28/2006
Last updated
04/24/2017
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