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General NPI Number Information
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NPI Number | 1902575871
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Entity Type | Organization
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Legal Business Name | NYS DOCCS WALSH RMU PHARMACY
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 6514 ROUTE 26 BUILDING 52
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City | ROME
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State | NY
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Zip | 13442-8450
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Country | US
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Telephone | 315-339-5232
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Fax |
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Provider Business Mailing Address
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Address Line | 6514 ROUTE 26 PO BOX 8450 BUILDING 52
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City | ROME
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State | NY
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Zip | 13442-8450
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Country | US
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Telephone | 315-339-5232
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Fax |
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Authorized Official
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Title or Position | PHARMACY SUPERVISOR
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Name | CARRIE RYAN
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Credential | RPH
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Telephone | 315-339-5232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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