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General NPI Number Information
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NPI Number | 1023293115
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Entity Type | Organization
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Legal Business Name | SIGNATURE RX INC
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 02/27/2014
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Provider Practice Location Address
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Address Line | 181 S PLANK RD
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City | NEWBURGH
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State | NY
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Zip | 12550-3054
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Country | US
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Telephone | 845-569-1700
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Fax | 845-569-1702
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Provider Business Mailing Address
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Address Line | PO BOX 765
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City | PLATTEKILL
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State | NY
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Zip | 12568-0765
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Country | US
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Telephone | 845-569-1700
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Fax | 845-569-1702
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE COICOU
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Credential | RPH
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Telephone | 845-633-2926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 028650
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License Number State | NY
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