MEDICARE: STONE'S PHARMACY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	013811	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699746297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STONE'S PHARMACY INC.

Provider Business Mailing Address
First Line	:	PO BOX 310
Second Line	:
City	:	LAKE LUZERNE
State	:	NY
Zip	:	12846-0310
Country	:	US
Telephone Number	:	518-696-3214
Fax Number	:	518-696-5192

Provider Business Practice Location Address
First Line	:	1 MAIN ST
Second Line	:
City	:	LAKE LUZERNE
State	:	NY
Zip	:	12846
Country	:	US
Telephone Number	:	518-696-3214
Fax Number	:	518-696-5192

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. LEIGH H MCCONCHIE
Credential	:
Telephone Number	:	518-696-3214

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	08/03/2012

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