Organization
FALLON WELLNESS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER LAWRENCE FALLON (PHARMACIST)
(518) 220-2005
Entity
Organization
Contact information
Practice address
1057 TROY SCHENECTADY RD, LATHAM, NY 12110-1002
(518) 220-2005
(518) 220-5004
Mailing address
1057 TROY SCHENECTADY RD, LATHAM, NY 12110-1002
(518) 220-2005
(518) 220-5004
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
026112
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02443983
—
NY
Enumeration date
02/07/2007
Last updated
08/22/2020
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