Organization
RL MT VERNON PHARMACY INC
Active
Other names
RL Mt. Vernon Pharmacy Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM EISENMAN (SUPERVISING PHARMACIST)
(914) 699-0235
Entity
Organization
Contact information
Practice address
107 W 4TH ST, MOUNT VERNON, NY 10550-4002
(914) 699-0235
(914) 699-3540
Mailing address
107 W 4TH ST, MOUNT VERNON, NY 10550-4002
(914) 699-0235
(914) 699-3540
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
031872
NY
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2141169
PK
—
05
—
3702072
—
NY
Enumeration date
06/11/2013
Last updated
12/11/2024
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