Healthcare Provider Details

I. General information

NPI: 1437012275
Provider Name (Legal Business Name): ADIRONDACK APOTHECARY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 MAIN ST
PORT HENRY NY
12974-1339
US

IV. Provider business mailing address

4315 MAIN ST
PORT HENRY NY
12974-1339
US

V. Phone/Fax

Practice location:
  • Phone: 518-546-7244
  • Fax: 518-546-9722
Mailing address:
  • Phone: 518-546-7244
  • Fax: 518-546-9722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. REBECCA L DOYLE
Title or Position: VICE-PRESIDENT
Credential: PHARMD
Phone: 518-532-0005