Organization Name: | GRAND AVENUE PHARMACY INC |
NPI Number: | 1760424055 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANTHONY TERRACCIANO (PRESIDENT SUP RPH) |
Mailing Address: | 69 29 Grand Ave Maspeth |
State: | NY US |
Postal Code: | 113781895 |
Phone Number: | 7188986882 |
Fax Number: | 7188982504 |
NPI Enumeration Date: | 06/12/2006 |
NPI Last Update Date: | 04/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |