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General NPI Number Information
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NPI Number | 1962129247
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Entity Type | Organization
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Legal Business Name | VINCE'S PHARMACY OF CAMILLUS INC
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Dates
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Enumeration Date | 10/26/2022
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 240 TOWNSHIP BLVD STE 30
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City | CAMILLUS
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State | NY
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Zip | 13031-1793
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Country | US
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Telephone | 315-487-5775
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Fax | 315-487-4423
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Provider Business Mailing Address
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Address Line | 240 TOWNSHIP BLVD STE 30
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City | CAMILLUS
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State | NY
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Zip | 13031-1793
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Country | US
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Telephone | 315-487-5775
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Fax | 315-487-4423
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL MACHEN
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Credential | PHARMD
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Telephone | 315-487-5775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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