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General NPI Number Information
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NPI Number | 1205174497
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Entity Type | Organization
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Legal Business Name | TOWN TOTAL HEALTH, LLC
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Dates
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Enumeration Date | 01/22/2013
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Last Update Date | 09/24/2020
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Provider Practice Location Address
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Address Line | 415 CROSSWAYS PARK DRIVE SUITE A
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City | WOODBURY
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State | NY
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Zip | 11797
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Country | US
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Telephone | 516-249-7400
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Fax | 516-249-7400
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Provider Business Mailing Address
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Address Line | 2929 WALKER AVE. NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49544-6402
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Country | US
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Telephone | 616-791-2829
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Fax | 616-735-8532
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Authorized Official
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Title or Position | CFO
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Name | PAUL A VALENTI
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Credential |
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Telephone | 631-386-1204
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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 | 031852
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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