NPI 1104916089 · live from the CMS NPI Registry
870 Southern Drug Corp.
Pharmacy, Community/Retail Pharmacy in Brooklyn, NY. National Provider Identifier 1104916089, active.
NPI record
| NPI | 1104916089 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Community/Retail Pharmacy 3336C0003X |
| Practice location | 924 Myrtle Avenue, Brooklyn, NY 11206 |
| Practice phone | 718-443-6000 |
| Mailing address | 40 Pennwood Place, Suite 300, Warrendale, PA 15086 |
| Enumerated | October 13, 2006 |
| Last updated | May 4, 2020 |
| Authorized official | Joseph Pohl, President & Ceo |
| Other names | Kingsboro Pharmacy |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacy | 333600000X | — |
| Pharmacy, Community/Retail Pharmacy primary | 3336C0003X | 029877 (NY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.