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General NPI Number Information
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NPI Number | 1255673745
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Entity Type | Organization
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Legal Business Name | LAGRANGE PHARMACY INC.
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Dates
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Enumeration Date | 03/22/2013
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Last Update Date | 05/09/2013
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Provider Practice Location Address
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Address Line | 1520 ROUTE 55 UNIT #16
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City | LAGRANGEVILLE
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State | NY
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Zip | 12540-5236
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Country | US
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Telephone | 845-447-1343
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Fax | 845-384-1115
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Provider Business Mailing Address
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Address Line | 1520 ROUTE 55 UNIT #16
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City | LAGRANGEVILLE
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State | NY
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Zip | 12540-5236
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Country | US
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Telephone | 845-447-1343
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Fax | 845-384-1115
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JEFFREY PAPO
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Credential | RPH
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Telephone | 845-447-1343
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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 | 031906
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License Number State | NY
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