Organization
ELMIRA CORRECTIONAL FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERIK WANDELL (SUPERVISING PHARMACIST)
(607) 734-3901
Entity
Organization
Contact information
Practice address
1879 DAVIS ST # 500, ELMIRA, NY 14901-1042
(607) 734-3901
Mailing address
1879 DAVIS ST # 500, ELMIRA, NY 14901-1042
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
—
—
Other
Enumeration date
09/17/2021
Last updated
09/17/2021
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