Organization
NYACK APOTHECARY INC
Active
Other names
Koblin's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY RUCKER (PRESIDENT)
(845) 358-0688
Entity
Organization
Contact information
Practice address
96 MAIN ST, NYACK, NY 10960-3110
(845) 358-0688
(914) 358-7966
Mailing address
96 MAIN ST, NYACK, NY 10960-3110
(845) 358-0688
(914) 358-7966
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
032294
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144105
PK
—
Enumeration date
06/28/2013
Last updated
06/24/2014
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