Organization
CANASTOTA PHARMACY DBA COMMUNITYPHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN JOHN KWASNIK RPH. (SUPERVISING PHARMACIST)
(315) 697-2541
Entity
Organization
Contact information
Practice address
149 S PETERBORO ST., CANASTOTA, NY 13032
(315) 697-2541
Mailing address
149 S PETERBORO ST., CANASTOTA, NY 13032
(315) 697-2541
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
024977
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02144567
—
NY
Enumeration date
10/02/2006
Last updated
02/14/2008
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