Healthcare Provider Details

I. General information

NPI: 1891786125
Provider Name (Legal Business Name): MONAHAN AND BROSWSKI PHARMACISTS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 10/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 CHURCH ST
HOOSICK FALLS NY
12090-1600
US

IV. Provider business mailing address

PO BOX 217
HOOSICK FALLS NY
12090-0217
US

V. Phone/Fax

Practice location:
  • Phone: 518-686-5711
  • Fax: 518-686-1706
Mailing address:
  • Phone: 518-686-5711
  • Fax: 518-686-1706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number030544-1
License Number StateNY

VIII. Authorized Official

Name: MR. JAMES E MONAHAN
Title or Position: OWNER/ PHARMACISTD
Credential:
Phone: 518-686-5711