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General NPI Number Information
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NPI Number | 1275676801
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Entity Type | Organization
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Legal Business Name | P.A.W. DRUG MART INC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 04/01/2008
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Provider Practice Location Address
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Address Line | 2711 MERRICK RD
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City | BELLMORE
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State | NY
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Zip | 11710-5719
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Country | US
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Telephone | 516-785-4774
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Fax | 516-785-4432
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Provider Business Mailing Address
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Address Line | 2711 MERRICK RD
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City | BELLMORE
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State | NY
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Zip | 11710-5719
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Country | US
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Telephone | 516-785-4774
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Fax | 516-785-4432
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Authorized Official
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Title or Position | OWNER
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Name | MR. PAUL A WURTZ
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Credential | RPH
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Telephone | 516-785-4774
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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 | 018803
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License Number State | NY
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