| NPI | 1215077532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER LAWRENCE FALLON Pharmacist 518-220-2005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: NY 026112) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |