Organization
ADIRONDACK PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW SCOTT R.PH. (PRESIDENT)
(315) 848-3784
Entity
Organization
Contact information
Practice address
4057 STATE HIGHWAY 3, STAR LAKE, NY 13690-0211
(315) 848-3784
(315) 848-5129
Mailing address
4057 STATE HIGHWAY 3, P.O. BOX 211, STAR LAKE, NY 13690-3172
(315) 848-3784
(315) 848-5129
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
025407
NY
3336L0003X
Long Term Care Pharmacy
025407
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02289669
—
NY
Enumeration date
10/17/2006
Last updated
09/11/2017
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