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General NPI Number Information
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NPI Number | 1306945647
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Entity Type | Organization
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Legal Business Name | GENOVESE DRUG STORES INC
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 02/01/2008
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Provider Practice Location Address
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Address Line | 106 BROADWAY
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City | GREENLAWN
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State | NY
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Zip | 11740-1310
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Country | US
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Telephone | 631-757-8200
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Fax | 631-757-7656
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Provider Business Mailing Address
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Address Line | 200 NEWBERRY COMMONS
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City | ETTERS
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State | PA
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Zip | 17319-9363
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER ONLINE ADJUDICATION
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Name | JENNIFER ZOREK
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Credential |
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Telephone | 717-975-5937
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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 | 026155
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License Number State | NY
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