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General NPI Number Information
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NPI Number | 1033155585
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Entity Type | Organization
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Legal Business Name | CLINTWOOD APOTHECARY LLC
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 343 CLINTON ST
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City | BINGHAMTON
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State | NY
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Zip | 13905-2017
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Country | US
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Telephone | 607-729-6972
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Fax | 607-729-0177
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Provider Business Mailing Address
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Address Line | PO BOX 345 WVS
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City | BINGHAMTON
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State | NY
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Zip | 13705-0345
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER / PRESIDENT
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Name | EDWARD LANDRY
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Credential | RPH
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Telephone | 607-727-7770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 023176
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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