Organization
CCRX OF NEW YORK, LLC
Active
Other names
MTM Pharmacy Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT D HABECKER (SECRETARY)
(717) 810-1950
Entity
Organization
Contact information
Practice address
84 PATRICK LN, POUGHKEEPSIE, NY 12603-2936
(845) 485-3784
(845) 485-2853
Mailing address
5775 ALLENTOWN BLVD, SUITE 101, HARRISBURG, PA 17112-4049
(717) 810-1950
(717) 810-1952
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
027843
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02749379
—
NY
Enumeration date
08/24/2006
Last updated
08/22/2020
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