Organization
COLONIAL LTC PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT BRAYTON LANGDON III RPH. (PRESIDENT)
(315) 868-4073
Entity
Organization
Contact information
Practice address
100 MAIN ST, SUITE 1, WHITESBORO, NY 13492-1027
(315) 868-4073
(315) 736-7396
Mailing address
100 MAIN ST, SUITE 1, WHITESBORO, NY 13492-1027
(315) 868-4073
(315) 736-7396
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
030513
NY
Other
Enumeration date
01/19/2011
Last updated
01/19/2011
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