| NPI | 1528453032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAIGE A WELLS Pharmacist In Charge 518-275-3926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 058209) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2015-04-01 |