# BARDONIA PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306686613
- **Authorized official:** JOHN MINA SAMUEL (OWNER/SUPERVISING PHARMACIST)
- **Authorized official phone:** (845) 507-0555

## Contact information

- **Practice address:** 301 ROUTE 304 STE 4, BARDONIA, NY 10954-2146
- **Practice address phone:** (845) 507-0555
- **Practice address fax:** (845) 507-0012
- **Mailing address:** 301 ROUTE 304 STE 4, BARDONIA, NY 10954-2146
- **Mailing address phone:** (845) 507-0555
- **Mailing address fax:** (845) 507-0012

## Taxonomy

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

## Other

- **Enumeration date:** 05/27/2024
- **Last updated:** 05/27/2024