Healthcare Provider Details

I. General information

NPI: 1972146769
Provider Name (Legal Business Name): MARRAS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2019
Last Update Date: 10/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 REMSEN ST
COHOES NY
12047-3024
US

IV. Provider business mailing address

PO BOX 229
COHOES NY
12047-0229
US

V. Phone/Fax

Practice location:
  • Phone: 518-237-2110
  • Fax: 518-237-5533
Mailing address:
  • Phone: 518-720-3147
  • Fax: 518-237-5533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BRUCE DAVID HATCH
Title or Position: DESIGNATED OFFICIAL/PHARMACIST
Credential:
Phone: 518-720-3147