Organization
RUSSELLS PHARMACY UPSTATE HOME RESPIRATORY EQUIPMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL ALEXANDER LAWRENCE (PRESIDENT)
(518) 654-2485
Entity
Organization
Contact information
Practice address
106 MAPLE ST, CORINTH, NY 12822-1026
(518) 654-2485
(518) 654-7555
Mailing address
106 MAPLE ST, CORINTH, NY 12822-1026
(518) 654-2485
(518) 654-7555
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01240995
—
NY
05
—
02570643
—
NY
01
—
10019380
CDPHP
NY
Enumeration date
07/11/2006
Last updated
08/22/2020
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