Organization
PARK RIDGE APOTHECARY, INC
Active
Other names
PARK RIDGE APOTHECARY INC
Organization subpart
No
Provider details
NPI number
Authorized official
MARYLYNN DANDREA RPH (SUPERVISOR,PIC,AO)
(585) 723-7340
Entity
Organization
Contact information
Practice address
1561 LONG POND RD, STE 104, ROCHESTER, NY 14626-4117
(585) 723-7340
(585) 723-7044
Mailing address
1561 LONG POND RD, STE 104, ROCHESTER, NY 14626-4117
(585) 723-7340
(585) 723-7044
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
019921
NY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01092626
—
NY
01
—
2065525
PK
—
Enumeration date
06/19/2006
Last updated
02/16/2017
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