Organization
BDRN PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE M SHERMAN R.PH. (SUPERVISING PHARMACIST)
(845) 467-4064
Entity
Organization
Contact information
Practice address
13 JAMES P KELLY WAY STE F, MIDDLETOWN, NY 10940
(845) 467-4064
(845) 467-4069
Mailing address
4 STEWART CT, DENVILLE, NJ 07834-1028
(845) 467-4064
(845) 467-4069
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
031701
NY
333600000X
Pharmacy
031701
NY
3336C0003X
Community/Retail Pharmacy
Primary
031701
NY
3336H0001X
Home Infusion Therapy Pharmacy
031701
NY
3336S0011X
Specialty Pharmacy
031701
NY
Other
Enumeration date
01/15/2013
Last updated
10/28/2020
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