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General NPI Number Information
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NPI Number | 1114095940
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Entity Type | Organization
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Legal Business Name | VINCENTS PHARMACY INC
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 07/09/2010
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Provider Practice Location Address
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Address Line | 3272 FRANKLIN AVE
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City | MILLBROOK
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State | NY
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Zip | 12545-5975
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Country | US
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Telephone | 845-677-3223
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Fax | 914-677-3225
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Provider Business Mailing Address
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Address Line | PO BOX 557
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City | MILLBROOK
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State | NY
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Zip | 12545-0557
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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 | PHARMACIST
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Name | MICHAEL GIORDANO
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Credential |
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Telephone | 845-677-3223
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 020418
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License Number State | NY
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