NPI: 1134547375 · WOODSIDE, NY 11377 · Pharmacy · NPI assigned 04/04/2014
| Authorized Official | SUTARIA, PANKIT (PRESIDENT) |
| NPI Enumeration Date | 04/04/2014 |
Other providers sharing the same authorized official: SUTARIA, PANKIT
| Provider | City | State | Total Paid |
|---|---|---|---|
| MEDICINE MAN RX LLC | HOBOKEN | NJ | $4K |
| TOP VALUE PHARMACY LLC | BRONX | NY | $1K |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 602 | $12K |
| 2022 | 183 | $6K |