Healthcare Provider Details

I. General information

NPI: 1366587057
Provider Name (Legal Business Name): LENNOX BROS PHARMACISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 CENTRAL PLZ
ILION NY
13357-1701
US

IV. Provider business mailing address

37 CENTRAL PLZ
ILION NY
13357-1701
US

V. Phone/Fax

Practice location:
  • Phone: 315-894-3333
  • Fax:
Mailing address:
  • Phone: 315-894-3333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number019329
License Number StateNY

VIII. Authorized Official

Name: WILLIAM THOMSON LENNOX
Title or Position: PHARMACIST
Credential: RPH
Phone: 315-894-3333