Organization
MAIN STREET PHARMACY INC
Active
Other names
Main Street Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TALHA AZEEM (PRESIDENT)
(914) 235-1000
Entity
Organization
Contact information
Practice address
761 MAIN ST, NEW ROCHELLE, NY 10805-1511
(914) 235-1000
(914) 235-1001
Mailing address
761 MAIN ST, NEW ROCHELLE, NY 10805-1511
(914) 235-1000
(914) 235-1001
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
034514
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2160219
PK
—
Enumeration date
05/18/2016
Last updated
01/18/2017
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