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General NPI Number Information
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NPI Number | 1578606430
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Entity Type | Organization
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Legal Business Name | MT.VERNON PRESCRIPTION INC.
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 02/02/2012
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Provider Practice Location Address
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Address Line | 105 STEVENS AVE
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City | MT VERNON
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State | NY
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Zip | 10550-2686
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Country | US
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Telephone | 914-664-0300
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Fax | 914-664-0857
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Provider Business Mailing Address
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Address Line | 105 STEVENS AVE
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City | MT VERNON
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State | NY
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Zip | 10550-2686
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Country | US
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Telephone | 914-664-0300
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Fax | 914-664-0857
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. GIRISH RASIKLAL PATEL
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Credential | REG.PHARMACIST
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Telephone | 914-664-0300
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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 | 020574
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License Number State | NY
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