Healthcare Provider Details

I. General information

NPI: 1194816868
Provider Name (Legal Business Name): VILLAGE CHEMISTS OF SETAUKET INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 03/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 MAIN ST
E SETAUKET NY
11733
US

IV. Provider business mailing address

226 MAIN ST
E SETAUKET NY
11733
US

V. Phone/Fax

Practice location:
  • Phone: 631-751-1333
  • Fax: 631-941-4800
Mailing address:
  • Phone: 631-751-1333
  • Fax: 631-941-4800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number008483
License Number StateNY

VIII. Authorized Official

Name: MR. MICHELE J DEANGELIS
Title or Position: PHARMACIST OWNER
Credential: RPH
Phone: 631-751-1333