MEDICARE: HUDSON REGIONAL LTC 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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336L0003X	Long Term Care Pharmacy	030542	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2128914	OTHER		PK

General Provider Information

NPI Number	:	1548567225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUDSON REGIONAL LTC PHARMACY INC

Provider Business Mailing Address
First Line	:	280 ROUTE 211 E
Second Line	:	SUITE 112
City	:	MIDDLETOWN
State	:	NY
Zip	:	10940-3109
Country	:	US
Telephone Number	:	845-341-2700
Fax Number	:	845-341-2715

Provider Business Practice Location Address
First Line	:	280 ROUTE 211 E
Second Line	:	SUITE 112
City	:	MIDDLETOWN
State	:	NY
Zip	:	10940-3109
Country	:	US
Telephone Number	:	845-341-2700
Fax Number	:	845-341-2715

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ANGELO ANGERAME
Credential	:	B.S., R.PH.
Telephone Number	:	845-341-2714

Provider Enumeration Date	:	02/16/2011
Last Update Date	:	06/17/2016

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Directions to “HUDSON REGIONAL LTC PHARMACY INC ” Practice Location

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