Healthcare Provider Details

I. General information

NPI: 1841041506
Provider Name (Legal Business Name): CMV PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2949 STATE ROUTE 370
CATO NY
13033-9755
US

IV. Provider business mailing address

2949 STATE ROUTE 370 STOP 3
CATO NY
13033-9755
US

V. Phone/Fax

Practice location:
  • Phone: 315-626-3161
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: COLIN VALENTA
Title or Position: PRESIDENT
Credential:
Phone: 607-323-1303