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Organization

GRASSY SPRAIN PHARMACY,INC

Active
Other names
GRASSY SPRAIN PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
ANTHONY JOHN CIARLETTA RPH (VICE PRESIDENT)
(914) 779-5133
Entity
Organization

Contact information

Practice address
640 TUCKAHOE RD, YONKERS, NY 10710-5705
(914) 779-5133
(914) 779-8202
Mailing address
640 TUCKAHOE RD, YONKERS, NY 10710-5705
(914) 779-5133
(914) 779-8202

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01741340
NY
01
017779
NYS BOARD OF PHARMACY LICENSE
NY
Enumeration date
06/11/2024
Last updated
06/11/2024
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