Healthcare Provider Details

I. General information

NPI: 1063496404
Provider Name (Legal Business Name): MARRAS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 05/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 REMSEN ST
COHOES NY
12047-3024
US

IV. Provider business mailing address

217 REMSEN ST PO BOX 229
COHOES NY
12047-3024
US

V. Phone/Fax

Practice location:
  • Phone: 518-237-2110
  • Fax: 518-237-5533
Mailing address:
  • Phone: 518-237-2110
  • Fax: 518-237-5533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number007907
License Number StateNY

VIII. Authorized Official

Name: MR. JOHN T MCDONALD III
Title or Position: PRESIDENT
Credential: RPH
Phone: 518-237-2110