# TACONIC PHARMACY INC

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

## Provider details

- **NPI number:** 1376387886
- **Authorized official:** ANTHONY JOHN CIARLETTA R.PH. (VICE PRESIDENT)
- **Authorized official phone:** (914) 245-3334

## Contact information

- **Practice address:** 3659 LEE RD, JEFFERSON VALLEY, NY 10535-1507
- **Practice address phone:** (914) 245-3334
- **Practice address fax:** (914) 245-4096
- **Mailing address:** 3659 LEE RD, JEFFERSON VALLEY, NY 10535-1507
- **Mailing address phone:** (914) 245-3334
- **Mailing address fax:** (914) 245-4096

## Taxonomy

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

## Other

- **Enumeration date:** 06/20/2024
- **Last updated:** 06/20/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 030654 | NYS BOARD LICENSE NUMBER | NY |
| 05 | — | 03351622 | — | NY |