# MAHOPAC PHARMACY INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962493452
- **Authorized official:** MR. LAURENCE MIRESSI (PRESIDENT)
- **Authorized official phone:** (845) 628-5600

## Contact information

- **Practice address:** 936 S LAKE BLVD, MAHOPAC, NY 10541-3242
- **Practice address phone:** (845) 628-5600
- **Practice address fax:** (845) 628-0219
- **Mailing address:** 936 S LAKE BLVD, MAHOPAC, NY 10541-3242
- **Mailing address phone:** (845) 628-5600
- **Mailing address fax:** (845) 628-0219

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 019627 | NY | Yes |

## Other

- **Enumeration date:** 11/02/2005
- **Last updated:** 02/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 01056082 | — | NY |