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General NPI Number Information
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NPI Number | 1063869238
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Entity Type | Organization
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Legal Business Name | MIDDLETOWN LTC PHARMACY LLC
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Dates
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Enumeration Date | 05/18/2016
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 280 ROUTE 211 E SUITE 112
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City | MIDDLETOWN
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State | NY
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Zip | 10940-3109
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Country | US
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Telephone | 845-341-2700
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Fax | 845-341-2715
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Provider Business Mailing Address
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Address Line | 280 ROUTE 211 E SUITE 112
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City | MIDDLETOWN
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State | NY
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Zip | 10940-3109
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Country | US
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Telephone | 845-341-2700
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Fax | 845-341-2715
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Authorized Official
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Title or Position | MEMBER
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Name | MAYUR PATEL
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Credential |
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Telephone | 845-341-2700
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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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