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General NPI Number Information
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NPI Number | 1659754208
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Entity Type | Organization
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Legal Business Name | PRICE CHOPPER OPERATING CO OF MASS INC
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Dates
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Enumeration Date | 07/01/2015
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Last Update Date | 06/27/2016
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Provider Practice Location Address
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Address Line | 21 GALAXY PASS
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City | SUTTON
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State | MA
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Zip | 01590-4836
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Country | US
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Telephone | 508-865-2513
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Fax | 508-865-5240
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Provider Business Mailing Address
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Address Line | 461 NOTT ST MB #202
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City | SCHENECTADY
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State | NY
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Zip | 12308-1812
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Country | US
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Telephone | 518-379-1618
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Fax | 518-356-6978
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Authorized Official
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Title or Position | VP OF PHARMACY
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Name | KATHLEEN BRYNAT
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Credential |
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Telephone | 518-379-1618
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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 | DS89978
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License Number State | MA
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