# HEALTHDIRECT INSTITUTIONAL PHARMACY SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Healthdirect Institutional Pharmacy Services, Inc. \#05
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972610699
- **Authorized official:** STACEY KRUTH (VP FINANCE)
- **Authorized official phone:** (315) 778-7651

## Contact information

- **Practice address:** 29 E MAIN ST, GOUVERNEUR, NY 13642-1401
- **Practice address phone:** (315) 287-5002
- **Practice address fax:** (315) 287-7099
- **Mailing address:** 29 E MAIN ST, GOUVERNEUR, NY 13642-1401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 013565 | NY | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/25/2006
- **Last updated:** 04/30/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00561940 | — | NY |
| 01 | — | 3342994 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |