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Organization
VANCO PHARMACY INC
Active
Organization
VANCO PHARMACY INC
Active
Other names
VANCO PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MITCHELL MELONE RPH (OWNER)
(631) 499-1111
Entity
Organization
Contact information
Practice address
30 VANDERBILT MOTOR PKWY, COMMACK, NY 11725-5410
(631) 499-1111
(631) 499-1127
Mailing address
30 VANDERBILT MOTOR PKWY, COMMACK, NY 11725-5410
(631) 499-1111
(631) 499-1127
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
024749
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02065869
—
NY
01
—
3380502
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/22/2006
Last updated
11/20/2024
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