Healthcare Provider Details

I. General information

NPI: 1013991033
Provider Name (Legal Business Name): TOTAL CARE PHARMACY J.V. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 02/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3659 LEE RD
JEFFERSON VALLEY NY
10535-1507
US

IV. Provider business mailing address

3659 LEE RD
JEFFERSON VALLEY NY
10535-1507
US

V. Phone/Fax

Practice location:
  • Phone: 914-245-3334
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number026554
License Number StateNY

VIII. Authorized Official

Name: MR. AMAR SETHI
Title or Position: SUPERVISING PHARMACIST
Credential:
Phone: 914-245-3334