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Organization
WOLCOTT VILLAGE PHARMACY INC
Active
Organization
WOLCOTT VILLAGE PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD THOMAS COLLEA (OWNER SUPERVISING PHARMACIST)
(315) 594-1212
Entity
Organization
Contact information
Practice address
12026 E MAIN ST, WOLCOTT, NY 14590-1022
(315) 594-1212
(315) 594-2971
Mailing address
12026 E MAIN ST, WOLCOTT, NY 14590-1022
(315) 594-1212
(315) 594-2971
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
040702
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01904796
—
NY
01
—
024126
STATE PHARMACY LICENSE
NY
01
—
3301998
NABP NUMBER
NY
Enumeration date
02/08/2007
Last updated
05/09/2011
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