NPI: 1932114543 · JACKSON HEIGHTS, NY 11372 · Pharmacy · NPI assigned 07/30/2006
| Authorized Official | WONG, KIM (OWNER PRESIDENT) |
| NPI Enumeration Date | 07/30/2006 |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 12 | $569.86 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| A4500 | Surgical stockings below knee length, each | 12 | 12 | $569.86 |