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General NPI Number Information
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NPI Number | 1649531963
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Entity Type | Organization
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Legal Business Name | ECKERSON DRUGS INC
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Dates
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Enumeration Date | 06/04/2012
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Last Update Date | 04/01/2015
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Provider Practice Location Address
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Address Line | 287 N MAIN ST
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City | SPRING VALLEY
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State | NY
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Zip | 10977-2914
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Country | US
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Telephone | 845-352-1800
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Fax | 845-352-8645
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Provider Business Mailing Address
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Address Line | 275 N MAIN ST UNIT 12/287
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City | SPRING VALLEY
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State | NY
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Zip | 10977-2915
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Country | US
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Telephone | 845-352-1800
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Fax | 845-352-8645
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Authorized Official
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Title or Position | OWNER/SUPERVISING PHARMACIST
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Name | ASHISH AMIN
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Credential | BS PHARMACY
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Telephone | 845-352-1800
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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 | 031396
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License Number State | NY
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