Healthcare Provider Details

I. General information

NPI: 1699748350
Provider Name (Legal Business Name): THRUWAY PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 OAK ST
WALDEN NY
12586-1054
US

IV. Provider business mailing address

78 OAK ST
WALDEN NY
12586-1054
US

V. Phone/Fax

Practice location:
  • Phone: 845-778-1388
  • Fax:
Mailing address:
  • Phone: 845-778-1388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number012219
License Number StateNY

VIII. Authorized Official

Name: LES CONCORS
Title or Position: OWNER
Credential:
Phone: 845-778-3535