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Organization
VINCE'S PHARMACY OF CAMILLUS INC
Active
Organization
VINCE'S PHARMACY OF CAMILLUS INC
Active
Other names
Medicine Shoppe LTC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL MACHEN PHARMD (PRESIDENT)
(315) 487-5775
Entity
Organization
Contact information
Practice address
240 TOWNSHIP BLVD STE 30, CAMILLUS, NY 13031-1793
(315) 487-5775
(315) 487-4423
Mailing address
240 TOWNSHIP BLVD STE 30, CAMILLUS, NY 13031-1793
(315) 487-5775
(315) 487-4423
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00905748
—
NY
01
—
018681
NYS
NY
01
—
0719740001
MEDICARE
NY
Enumeration date
10/26/2022
Last updated
03/07/2023
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