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Organization

SULLIVAN PHARMACY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MUHAMMAD KHALIQUE QURESHI RPH (SUPERVISING PHARMACIST/OWNER)
(845) 295-5456
Entity
Organization

Contact information

Practice address
267 NORTH MAIN ST, LIBERTY, NY 12754-1846
(845) 295-5456
(845) 295-5458
Mailing address
267 NORTH MAIN ST, LIBERTY, NY 12754-1846
(845) 295-5456
(845) 295-5458

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02632740
NY
01
3343148
PHARMACY NCPDP
Enumeration date
10/03/2006
Last updated
02/27/2023
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