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Organization
GRASSY SPRAIN PHARMACY,INC
Active
Organization
GRASSY SPRAIN PHARMACY,INC
Active
Other names
GRASSY SPRAIN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY JOHN CIARLETTA RPH (VICE PRESIDENT)
(914) 779-5133
Entity
Organization
Contact information
Practice address
640 TUCKAHOE RD, YONKERS, NY 10710-5705
(914) 779-5133
(914) 779-8202
Mailing address
640 TUCKAHOE RD, YONKERS, NY 10710-5705
(914) 779-5133
(914) 779-8202
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01741340
—
NY
01
—
017779
NYS BOARD OF PHARMACY LICENSE
NY
Enumeration date
06/11/2024
Last updated
06/11/2024
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