| NPI | 1881707271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT A MAINELLA Pharmacy Third Party Administrator 518-379-1618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CT PCY1831) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2009-03-10 |