Provider Demographics
NPI:1881459212
Name:GARDEN PHARMACY GROUP, INC.
Entity type:Organization
Organization Name:GARDEN PHARMACY GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AO
Authorized Official - Middle Name:SI
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-961-8800
Mailing Address - Street 1:4343 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-4743
Mailing Address - Country:US
Mailing Address - Phone:718-961-8800
Mailing Address - Fax:718-961-8200
Practice Address - Street 1:4343 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4743
Practice Address - Country:US
Practice Address - Phone:718-961-8800
Practice Address - Fax:718-961-8200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-15
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy