Healthcare Provider Details

I. General information

NPI: 1811953201
Provider Name (Legal Business Name): NAPLES PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 03/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S MAIN ST
NAPLES NY
14512-9574
US

IV. Provider business mailing address

PO BOX 696
WATKINS GLEN NY
14891-0696
US

V. Phone/Fax

Practice location:
  • Phone: 585-374-2080
  • Fax: 585-374-6903
Mailing address:
  • Phone: 607-535-4999
  • Fax: 607-535-4320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number018950
License Number StateNY

VIII. Authorized Official

Name: LAWRENCE A. JEPSEN
Title or Position: PRESIDENT
Credential:
Phone: 607-535-4999