4th Ave Drug Store INC
NPI #1295299535 in Mount Vernon, New York
Provider Information
- NPI Number
- 1295299535
- Entity Type
- Organization
- Organization Name
- 4th Ave Drug Store INC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Jan 30, 2019
- Last Updated
- Jun 8, 2020
Practice Location
- Address
- 26 S 4TH AVE
- City
- Mount Vernon
- State
- New York
- ZIP Code
- 10550-3105
- Phone
- (914) 863-0399
Authorized Official
- Name
- BIBI ESAHACK
- Title
- PRESIDENT
- Phone
- (914) 863-0399
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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