| NPI | 1396330932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STUART WRIGHT CFO 315-464-5179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2021-03-05 |
| Last Update Date | 2021-03-05 |