Healthcare Provider Details

I. General information

NPI: 1144586066
Provider Name (Legal Business Name): QUINLANS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 01/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 WEST MAIN STREET
MONTOUR FALLS NY
14865
US

IV. Provider business mailing address

107 NORTH MAIN STREET
WAYLAND NY
14572
US

V. Phone/Fax

Practice location:
  • Phone: 607-210-4262
  • Fax: 607-210-4201
Mailing address:
  • Phone: 585-728-2250
  • Fax: 585-728-9120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number031366
License Number StateNY

VIII. Authorized Official

Name: JOHN QUINLAN
Title or Position: OWNER
Credential:
Phone: 585-728-2250