Organization
MEDWIZ PHARMACY LLC
Active
Other names
MEDWIZ PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC NEWHOUSE (CEO)
(845) 624-5200
Entity
Organization
Contact information
Practice address
240 N MAIN ST, SPRING VALLEY, NY 10977-4020
(845) 624-5200
(845) 624-5300
Mailing address
240 N MAIN ST, SPRING VALLEY, NY 10977-4020
(845) 624-5200
(845) 624-5300
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
28RO00140500
NJ
3336L0003X
Long Term Care Pharmacy
029312
NY
3336L0003X
Long Term Care Pharmacy
Primary
PH30176
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04418659
—
NY
05
—
0548826
—
NJ
01
—
2170111
PK
—
Enumeration date
07/28/2017
Last updated
07/28/2017
About Stedi
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