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General NPI Number Information
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NPI Number | 1366898207
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Entity Type | Organization
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Legal Business Name | NATURES APOTHECARY LLC
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Dates
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Enumeration Date | 05/10/2016
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Last Update Date | 07/12/2016
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Provider Practice Location Address
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Address Line | 301 S MEADOW ST
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City | ITHACA
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State | NY
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Zip | 14850-5215
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Country | US
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Telephone | 607-273-3100
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Fax | 607-273-7979
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Provider Business Mailing Address
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Address Line | 301 S MEADOW ST
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City | ITHACA
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State | NY
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Zip | 14850-5215
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Country | US
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Telephone | 607-273-3100
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Fax | 607-273-7979
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Authorized Official
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Title or Position | OWNER/ PHARMACIST
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Name | SHAWN BURKE
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Credential |
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Telephone | 607-273-3100
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 034303
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License Number State | NY
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