Organization
ACME MARKETS INC
Active
Other names
ACME PHARMACY #2418
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
3071 E MAIN ST, MOHEGAN LAKE, NY 10547
(914) 526-0240
(914) 526-0244
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706-3940
(208) 395-3920
(623) 282-3834
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
034010
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154251
PK
—
Enumeration date
08/20/2015
Last updated
11/27/2018
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