Organization
PENN TRAFFIC COMPANY, THE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL J. MAHONEY J.D. (VICE PRESIDENT/CORPROATE COUNCIL)
(315) 461-2347
Entity
Organization
Contact information
Practice address
1200 STATE FAIR BLVD, SYRACUSE, NY 13209-1070
(315) 461-2600
(315) 461-2304
Mailing address
1200 STATE FAIR BLVD, SYRACUSE, NY 13209-1070
(315) 461-2600
(315) 461-2304
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
449
NCPDP CHAIN CODE
—
01
—
452
NCPCP CHAIN CODE
—
01
—
454
NCPDP CHAIN CODE
—
01
—
993
NCPDP FRANCHISE CODE
—
Enumeration date
04/04/2008
Last updated
04/04/2008
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