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General NPI Number Information
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NPI Number | 1598870370
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Entity Type | Organization
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Legal Business Name | BUONADONNA'S SHOPRITE LLC
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 03/12/2018
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Provider Practice Location Address
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Address Line | 50-110 ROUTE 108
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City | WEST BABYLON
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State | NY
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Zip | 11704
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Country | US
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Telephone | 631-587-3150
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Fax | 631-587-3128
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Provider Business Mailing Address
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Address Line | 64 RT 109
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City | WEST BABYLON
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State | NY
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Zip | 11704
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Country | US
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Telephone | 631-587-2943
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Fax | 631-587-3128
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Authorized Official
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Title or Position | PRESIDENT
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Name | MELISSA BUONADONNA
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Credential |
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Telephone | 631-666-7737
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 029911
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License Number State | NY
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