Individual
BRIAN J MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1549 ROUTE 9, WALMART PHARMACY, HALFMOON, NY 12065-5603
(518) 373-5732
(518) 373-5753
Mailing address
1549 ROUTE 9, WALMART PHARMACY, HALFMOON, NY 12065-5603
(518) 373-5732
(518) 373-5753
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
044401
NY
Other
Enumeration date
02/09/2010
Last updated
02/09/2010
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