Healthcare Provider Details

I. General information

NPI: 1396753398
Provider Name (Legal Business Name): HOERNING PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 03/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 HOPE PLZ
WEST COXSACKIE NY
12192-1225
US

IV. Provider business mailing address

34 HOPE PLAZA
WEST COXACKIE NY
12192
US

V. Phone/Fax

Practice location:
  • Phone: 518-731-2400
  • Fax:
Mailing address:
  • Phone: 518-731-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number013820
License Number StateNY

VIII. Authorized Official

Name: MR. EUGENE C HOERNING
Title or Position: PRESIDENT
Credential: RPH
Phone: 518-731-2400