# PENN TRAFFIC COMPANY, THE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023281540
- **Authorized official:** MR. DANIEL J. MAHONEY J.D. (VICE PRESIDENT/CORPROATE COUNCIL)
- **Authorized official phone:** (315) 461-2347

## Contact information

- **Practice address:** 1200 STATE FAIR BLVD, SYRACUSE, NY 13209-1070
- **Practice address phone:** (315) 461-2600
- **Practice address fax:** (315) 461-2304
- **Mailing address:** 1200 STATE FAIR BLVD, SYRACUSE, NY 13209-1070
- **Mailing address phone:** (315) 461-2600
- **Mailing address fax:** (315) 461-2304

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 04/04/2008
- **Last updated:** 04/04/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 449 | NCPDP CHAIN CODE | — |
| 01 | — | 452 | NCPCP CHAIN CODE | — |
| 01 | — | 454 | NCPDP CHAIN CODE | — |
| 01 | — | 993 | NCPDP FRANCHISE CODE | — |