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General NPI Number Information
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NPI Number | 1073965729
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Entity Type | Organization
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Legal Business Name | PROPEL PHARMACY, LLC
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Dates
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Enumeration Date | 07/06/2016
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 5962 STATE ROUTE 31 STE 4
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City | CICERO
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State | NY
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Zip | 13039-7857
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Country | US
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Telephone | 888-407-8015
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Fax | 866-277-1796
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Provider Business Mailing Address
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Address Line | 5962 STATE ROUTE 31 STE 4
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City | CICERO
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State | NY
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Zip | 13039-7857
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Country | US
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Telephone | 888-407-8015
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Fax | 866-277-1796
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | ERICA RACHELLE DURANT
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Credential | PHARMD
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Telephone | 888-407-8015
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 034875
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License Number State | NY
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