# GRASSY SPRAIN PHARMACY,INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GRASSY SPRAIN PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225870090
- **Authorized official:** ANTHONY JOHN CIARLETTA RPH (VICE PRESIDENT)
- **Authorized official phone:** (914) 779-5133

## Contact information

- **Practice address:** 640 TUCKAHOE RD, YONKERS, NY 10710-5705
- **Practice address phone:** (914) 779-5133
- **Practice address fax:** (914) 779-8202
- **Mailing address:** 640 TUCKAHOE RD, YONKERS, NY 10710-5705
- **Mailing address phone:** (914) 779-5133
- **Mailing address fax:** (914) 779-8202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 06/11/2024
- **Last updated:** 06/11/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 01741340 | — | NY |
| 01 | — | 017779 | NYS BOARD OF PHARMACY LICENSE | NY |