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General NPI Number Information
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NPI Number | 1952469405
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Entity Type | Organization
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Legal Business Name | NASSAU PHARMACY, INC.
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 11/05/2018
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Provider Practice Location Address
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Address Line | 3541 US HIGHWAY 20
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City | NASSAU
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State | NY
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Zip | 12123-1931
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Country | US
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Telephone | 518-588-4717
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Fax |
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Provider Business Mailing Address
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Address Line | 3541 US ROUTE 20 PO BOX 824
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City | NASSAU
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State | NY
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Zip | 12123-3300
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Country | US
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Telephone | 518-766-2707
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS CATHY GROSSMAN
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Credential |
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Telephone | 518-766-2707
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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 | 019984
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License Number State | NY
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