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Organization
ER BLACK PHARMACY INC
Active
Organization
ER BLACK PHARMACY INC
Active
Other names
Holland Patent Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EARL ROBERT BLACK JR. R PH (PRESIDENT PHARMACIST)
(315) 865-8141
Entity
Organization
Contact information
Practice address
9553 MAIN STREET, HOLLAND PATENT, NY 13354-0205
(315) 865-8141
(315) 865-4318
Mailing address
9553 MAIN ST, HOLLAND PATENT, NY 13354
(315) 865-8141
(315) 865-4318
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
024930
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02139724
—
NY
01
—
3332727
NABP #
NY
Enumeration date
01/02/2007
Last updated
11/26/2013
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