Organization
FOUR CORNERS PHARMACY LLC
Active
Other names
Four Corners Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN L CROCE RPH (CO-OWNER)
(518) 439-8200
Entity
Organization
Contact information
Practice address
360 DELAWARE AVE, DELMAR, NY 12054-1904
(518) 439-8200
(518) 439-3657
Mailing address
360 DELAWARE AVE, DELMAR, NY 12054-1904
(518) 439-8200
(518) 439-3657
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
027103
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02634426
—
NY
Enumeration date
08/25/2006
Last updated
08/06/2013
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