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General NPI Number Information
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NPI Number | 1407231319
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Entity Type | Organization
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Legal Business Name | NYCO CHEMISTS IV INC.
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Dates
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Enumeration Date | 07/22/2015
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Last Update Date | 07/22/2015
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Provider Practice Location Address
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Address Line | 18 HAMPTON RD
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City | SOUTHAMPTON
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State | NY
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Zip | 11968-4930
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Country | US
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Telephone | 631-287-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 18 HAMPTON RD
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City | SOUTHAMPTON
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State | NY
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Zip | 11968-4930
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Country | US
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Telephone | 631-287-2900
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | CHRISTOS TSIOROS
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Credential |
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Telephone | 631-287-2900
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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 | 033721
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License Number State | NY
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