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Organization
PORTVILLE PHARMACY,INC.
Active
Organization
PORTVILLE PHARMACY,INC.
Active
Other names
Dunn's Drugstore
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MOIRA E AHL PHARM.D (SUPERVISING PHARMACIST)
(585) 928-1530
Entity
Organization
Contact information
Practice address
323 MAIN ST, BOLIVAR, NY 14715-1108
(585) 928-1530
(585) 928-2972
Mailing address
323 MAIN ST, BOLIVAR, NY 14715-1108
(585) 928-1530
(585) 928-2972
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
017472
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00623309
—
NY
Enumeration date
12/18/2006
Last updated
08/22/2020
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