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Organization
PEG APOTHECARY INC
Active
Organization
PEG APOTHECARY INC
Active
Other names
Emerald Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM SHAWN NEALIS RPH (PRESIDENT)
(718) 944-0862
Entity
Organization
Contact information
Practice address
4295 KATONAH AVE, BRONX, NY 10470
(718) 944-0862
(718) 944-0864
Mailing address
4295 KATONAH AVE, BRONX, NY 10470
(718) 944-0862
(718) 944-0864
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
047516
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00290857
—
NY
01
—
025341
NYS PHARMACY LIC
NY
01
—
3325835
NABP
NY
Enumeration date
10/04/2006
Last updated
03/07/2023
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