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Provider Information for 1124763982


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GRUM CORPORATION

Other Names:  
Doing Business As: 
AZE PHARMACY

Organization Subpart: NO

NPI: 1124763982
Last Updated: 2024-09-20
Certification Date: 2024-09-20

Details

NameValue
NPI1124763982
Enumeration Date2022-05-04
NPI TypeNPI-2 Organization
StatusActive
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
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 3336C0003X - Pharmacy - Community/Retail Pharmacy