Healthcare Provider Details
I. General information
NPI: 1649704792
Provider Name (Legal Business Name): STEED ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/16/2017
Last Update Date: 04/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7 MAIN ST
CANISTEO NY
14823-1125
US
IV. Provider business mailing address
2630 HONEYSUCKLE LN
ELMIRA NY
14903-9352
US
V. Phone/Fax
- Phone: 607-698-4641
- Fax: 607-698-2527
- Phone: 607-731-4432
- Fax: 607-698-2527
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 035401 |
| License Number State | NY |
VIII. Authorized Official
Name: MR.
FRANK
STEED
Title or Position: OWNER
Credential:
Phone: 607-698-4641