| NPI | 1174911754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIKA A FALLON Supervising Pharmacist 518-220-2005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 052563) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2015-01-05 |