| NPI | 1669299558 |
|---|---|
| Doing Business As | MADISON AVE PHARMACY LTC |
| Entity Type | Organization |
| Authorized Contact | SRINIVAS VELESETTY President/Owner 518-971-8999 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2024-09-23 |
| Last Update Date | 2024-09-23 |