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General NPI Number Information
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NPI Number | 1306912076
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Entity Type | Organization
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Legal Business Name | MEAD SQUARE PHARMACY INC
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 7249 STATE ROUTE 96
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City | VICTOR
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State | NY
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Zip | 14564-9009
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Country | US
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Telephone | 585-924-7970
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Fax | 585-924-8329
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Provider Business Mailing Address
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Address Line | 7249 STATE ROUTE 96
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City | VICTOR
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State | NY
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Zip | 14564-9009
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Country | US
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Telephone | 585-924-7970
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Fax | 585-924-8329
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CHRISTOPHER KEVIN CASEY
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Credential | R.PH.
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Telephone | 585-924-7970
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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 | 025452
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License Number State | NY
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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 |
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License Number State |
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