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General NPI Number Information
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NPI Number | 1043988066
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Entity Type | Organization
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Legal Business Name | INNOVATION PHARMACY INC
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Dates
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Enumeration Date | 09/03/2021
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Last Update Date | 09/03/2021
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Provider Practice Location Address
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Address Line | 1097 LOUDEN
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City | COHOES
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State | NY
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Zip | 12047-4903
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Country | US
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Telephone | 518-783-1210
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Fax |
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Provider Business Mailing Address
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Address Line | 1097 LOUDEN
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City | COHOES
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State | NY
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Zip | 12047-4903
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Country | US
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Telephone | 187-831-2105
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | OSAMAH AWAD
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Credential | PHARMD
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Telephone | 518-783-1210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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