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General NPI Number Information
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NPI Number | 1578379996
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Entity Type | Organization
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Legal Business Name | PURECARE PHARMACY AND WELLNESS INC
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 65 GLEN COVE RD
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City | GREENVALE
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State | NY
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Zip | 11548-1007
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Country | US
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Telephone | 516-277-2668
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Fax | 516-277-2671
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Provider Business Mailing Address
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Address Line | 65 GLEN COVE RD
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City | GREENVALE
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State | NY
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Zip | 11548-1007
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Country | US
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Telephone | 914-330-1499
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TOM AMIGDALOS
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Credential | R.PH
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Telephone | 516-277-2668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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