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Organization
TACONIC PHARMACY INC
Active
Organization
TACONIC PHARMACY INC
Active
Other names
TACONIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY JOHN CIARLETTA R.PH. (VICE PRESIDENT)
(914) 245-3334
Entity
Organization
Contact information
Practice address
3659 LEE RD, JEFFERSON VALLEY, NY 10535-1507
(914) 245-3334
(914) 245-4096
Mailing address
3659 LEE RD, JEFFERSON VALLEY, NY 10535-1507
(914) 245-3334
(914) 245-4096
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030654
NYS BOARD LICENSE NUMBER
NY
05
—
03351622
—
NY
Enumeration date
06/20/2024
Last updated
06/20/2024
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