Provider Information for 1124763982
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GRUM CORPORATION
Other Names:Doing Business As:AZE PHARMACYOrganization Subpart: NO
NPI: 1124763982
Last Updated: 2024-09-20
Certification Date: 2024-09-20
Certification Date: 2024-09-20
Details
Name | Value | ||||||||
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NPI | 1124763982 | ||||||||
Enumeration Date | 2022-05-04 | ||||||||
NPI Type | NPI-2 Organization | ||||||||
Status | Active | ||||||||
Authorized Official Information | Name: Mr. MUHAMMAD HASNAIN Title: President Phone: 7185763476 | ||||||||
Mailing Address | 4519 7TH AVE BROOKLYN, NY 11220-1495 United States Phone: 718-576-3476 | Fax:718-576-3459 | ||||||||
Primary Practice Address | 4519 7TH AVE BROOKLYN, NY 11220-1495 United States Phone: 718-576-3476 | Fax:718-576-3459 | ||||||||
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