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General NPI Number Information
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NPI Number | 1134279888
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Entity Type | Organization
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Legal Business Name | BOICEVILLE PHARMACY INC.
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 4103 RT 28
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City | BOICEVILLE
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State | NY
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Zip | 12412
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Country | US
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Telephone | 845-657-6511
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Fax | 845-657-9854
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Provider Business Mailing Address
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Address Line | PO BOX 474
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City | BOICEVILLE
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State | NY
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Zip | 12412-0474
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Country | US
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Telephone | 845-657-6511
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Fax | 845-657-9854
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Authorized Official
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Title or Position | PIC
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Name | PETER GEORGE NEKOS
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Credential |
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Telephone | 845-657-6511
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 021274
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License Number State | NY
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