| NPI | 1710332002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JOHN FORREST Outpatient Pharmacy Director 607-798-5944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NY 029413) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2020-04-03 |