Organization
MONROE AVENUE PHARMACY INC
Active
Other names
Rushville Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DANA GIGNAC (SUPERVISING R.PH.)
(585) 554-4001
Entity
Organization
Contact information
Practice address
2 SOUTH MAIN ST, RUSHVILLE, NY 14544
(585) 554-4001
Mailing address
2 SOUTH MAIN ST, RUSHVILLE, NY 14544
(585) 554-4001
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
031215
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5805075
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/02/2012
Last updated
11/23/2012
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