Organization
JEFFERSON PHARMACY INC
Active
Other names
Jefferson Pharmacy INC
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA NEUMANN (OPERATING OFFICER)
(845) 482-5720
Entity
Organization
Contact information
Practice address
4892 STATE ROUTE 52, JEFFERSONVILLE, NY 12748-5617
(845) 482-5720
(845) 482-5771
Mailing address
PO BOX 617, JEFFERSONVILLE, NY 12748-0617
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
029537
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2141164
PK
—
05
—
3114490
—
NY
Enumeration date
06/06/2006
Last updated
09/23/2014
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