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General NPI Number Information
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NPI Number | 1699868026
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Entity Type | Organization
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Legal Business Name | GREENLEAF PHARMACY LLC
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Dates
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Enumeration Date | 09/30/2006
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Last Update Date | 09/30/2013
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Provider Practice Location Address
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Address Line | 544 WARBURTON AVE
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City | HASTINGS ON HUDSON
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State | NY
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Zip | 10706-1549
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Country | US
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Telephone | 914-478-0004
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Fax | 914-478-1220
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Provider Business Mailing Address
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Address Line | 544 WARBURTON AVE
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City | HASTINGS ON HUDSON
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State | NY
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Zip | 10706-1549
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Country | US
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Telephone | 914-478-0004
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Fax | 914-478-1220
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Authorized Official
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Title or Position | VP OPERATIONS
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Name | SAISATISH GUNDA
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Credential |
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Telephone | 914-478-0004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 031771
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License Number State | NY
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