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General NPI Number Information
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NPI Number | 1538178942
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Entity Type | Organization
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Legal Business Name | VALUE VILLAGE II, LLC
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 270 PORTION RD
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City | LAKE RONKONKOMA
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State | NY
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Zip | 11779-2348
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Country | US
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Telephone | 631-913-2700
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Fax | 631-913-0645
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Provider Business Mailing Address
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Address Line | 270 PORTION RD
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City | LAKE RONKONKOMA
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State | NY
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Zip | 11779-2348
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Country | US
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Telephone | 631-913-2700
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Fax | 631-913-0645
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MR. JOHN A CALAMIS
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Credential |
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Telephone | 631-913-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 026332
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License Number State | NY
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