Healthcare Provider Details

I. General information

NPI: 1447311030
Provider Name (Legal Business Name): OCONNOR HOSPITAL PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 02/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 ANDES RD
DELHI NY
13753-7407
US

IV. Provider business mailing address

460 ANDES RD
DELHI NY
13753-7407
US

V. Phone/Fax

Practice location:
  • Phone: 607-746-0365
  • Fax: 607-746-0360
Mailing address:
  • Phone: 607-746-0365
  • Fax: 607-746-0360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number023558
License Number StateNY

VIII. Authorized Official

Name: ERIN KINGSBURY
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 607-746-0332