# CCRX OF NEW YORK, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MTM Pharmacy Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083721104
- **Authorized official:** MR. SCOTT D HABECKER (SECRETARY)
- **Authorized official phone:** (717) 810-1950

## Contact information

- **Practice address:** 84 PATRICK LN, POUGHKEEPSIE, NY 12603-2936
- **Practice address phone:** (845) 485-3784
- **Practice address fax:** (845) 485-2853
- **Mailing address:** 5775 ALLENTOWN BLVD, SUITE 101, HARRISBURG, PA 17112-4049
- **Mailing address phone:** (717) 810-1950
- **Mailing address fax:** (717) 810-1952

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 027843 | NY | Yes |

## Other

- **Enumeration date:** 08/24/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02749379 | — | NY |