Organization
PROACT PHARMACY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA L WEIR (THIRD PARTY ADMINISTRATOR)
(315) 287-3600
Entity
Organization
Contact information
Practice address
1226 US HIGHWAY 11, GOUVERNEUR, NY 13642-1401
(866) 287-9885
(315) 287-3330
Mailing address
29 E MAIN ST, GOUVERNEUR, NY 13642-1401
(315) 287-3600
(315) 287-4291
Taxonomy
Speciality
Code
Description
License number
State
3336M0002X
Mail Order Pharmacy
Primary
026479
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3335468
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/25/2006
Last updated
04/04/2014
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