Organization
SLOCUM-DICKSON PHARMACY INC
Active
Other names
SLOCUM DICKSON PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN PELLITTIERI RPH (DIRECTOR OF PHARMACY)
(315) 798-1724
Entity
Organization
Contact information
Practice address
1729 BURRSTONE RD, STE 201, NEW HARTFORD, NY 13413-1001
(315) 798-1724
(315) 798-1507
Mailing address
1729 BURRSTONE RD, STE 201, NEW HARTFORD, NY 13413-1001
(315) 798-1724
(315) 798-1507
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
019678
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01061238
—
NY
01
—
3391086
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/02/2005
Last updated
10/02/2012
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