Organization
SOUTHRIFTY DRUG INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT EMIL GRISNIK (PRESIDENT/SUPERVISING PHARMACIST)
(631) 283-1506
Entity
Organization
Contact information
Practice address
54 JAGGER LANE, SOUTHAMPTON, NY 11968
(631) 283-1506
(631) 283-4936
Mailing address
54 JAGGER LANE, SOUTHAMPTON, NY 11968
(631) 283-1506
(631) 283-4936
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
007552
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00665090
—
NY
Enumeration date
09/07/2006
Last updated
08/22/2020
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