# MEDWIZ PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MEDWIZ PHARMACY LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093239337
- **Authorized official:** ERIC NEWHOUSE (CEO)
- **Authorized official phone:** (845) 624-5200

## Contact information

- **Practice address:** 240 N MAIN ST, SPRING VALLEY, NY 10977-4020
- **Practice address phone:** (845) 624-5200
- **Practice address fax:** (845) 624-5300
- **Mailing address:** 240 N MAIN ST, SPRING VALLEY, NY 10977-4020
- **Mailing address phone:** (845) 624-5200
- **Mailing address fax:** (845) 624-5300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 28RO00140500 | NJ | — |
| 3336L0003X | Long Term Care Pharmacy | 029312 | NY | — |
| 3336L0003X | Long Term Care Pharmacy | PH30176 | FL | Yes |

## Other

- **Enumeration date:** 07/28/2017
- **Last updated:** 07/28/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 04418659 | — | NY |
| 05 | — | 0548826 | — | NJ |
| 01 | — | 2170111 | PK | — |