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Organization
KEESEVILLE PHARMACY INC
Active
Organization
KEESEVILLE PHARMACY INC
Active
Other names
Keeseville Pharmacy, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL BOSLEY (PHARMACIST)
(518) 834-6090
Entity
Organization
Contact information
Practice address
1730 FRONT ST, KEESEVILLE, NY 12944-3618
(518) 834-6090
(518) 834-7021
Mailing address
1730 FRONT ST, KEESEVILLE, NY 12944-3618
(518) 834-6090
(518) 834-7021
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
017834
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00775571
—
NY
01
—
2169937
PK
—
Enumeration date
06/13/2017
Last updated
07/19/2018
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