| NPI | 1255487419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKKI BANIEWICZ General Counsel 315-559-3699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: PA pp412212l) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2007-01-28 |
| Last Update Date | 2019-08-06 |