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Organization

RANDOLPH J WEAVER

Active
Other names
Village Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
RANDOLPH WEAVER (OWNER/RPH)
(607) 664-9039
Entity
Organization

Contact information

Practice address
7181 STATE ROUTE 54, BATH, NY 14810-9502
(607) 664-9039
Mailing address
7181 STATE ROUTE 54, BATH, NY 14810
(607) 664-9039

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
034106
NY
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2157398
PK
Enumeration date
01/05/2016
Last updated
01/25/2016
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