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Organization
WASHINGTONVILLE PHARMACY INC
Active
Organization
WASHINGTONVILLE PHARMACY INC
Active
Other names
WASHINGTONVILLE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARK PATRICK FREITAS (RPH)
(845) 496-8001
Entity
Organization
Contact information
Practice address
32 W MAIN ST UNIT 2, WASHINGTONVILLE, NY 10992-1411
(845) 496-8001
(845) 496-8005
Mailing address
32 W MAIN ST UNIT 2, WASHINGTONVILLE, NY 10992-1411
(845) 496-8001
(845) 496-8005
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
028235
NY
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02891303
—
NY
01
—
2069038
PK
—
Enumeration date
03/15/2007
Last updated
08/31/2022
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