Healthcare Provider Details

I. General information

NPI: 1386793859
Provider Name (Legal Business Name): ESQUIRE DRUG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 07/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RT. 40 AND CHURCH ST.
MELROSE NY
12121
US

IV. Provider business mailing address

PO BOX 1
MELROSE NY
12121-0001
US

V. Phone/Fax

Practice location:
  • Phone: 518-235-2022
  • Fax: 518-235-2082
Mailing address:
  • Phone: 518-235-2022
  • Fax: 518-235-2082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number018073-1
License Number StateNY

VIII. Authorized Official

Name: MR. ROBERT ARMAN MESSIA I
Title or Position: PHARMACIST
Credential:
Phone: 518-235-2022