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NPI Code Detail

MEDICARE: MARION PHARMACY, INC.

MEDICARE: MARION PHARMACY, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy022531NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437147717
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARION PHARMACY, INC.
Provider Business Mailing Address
First Line : PO BOX 47
Second Line :
City : MARION
State : NY
Zip : 14505-0047
Country : US
Telephone Number : 315-926-5636
Fax Number :
Provider Business Practice Location Address
First Line : 3803 SOUTH MAIN ST.
Second Line :
City : MARION
State : NY
Zip : 14505
Country : US
Telephone Number : 315-926-5636
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. PAUL E. JOHNSON
Credential : RPH
Telephone Number : 315-926-5636
Provider Enumeration Date : 10/11/2005
Last Update Date : 11/23/2009

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Directions to “MARION PHARMACY, INC. ” Practice Location

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