Organization
WAYNE DRUG OF PULASKI, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES BRANSHAW (VICE PRESIDENT)
(315) 343-5722
Entity
Organization
Contact information
Practice address
24 W BRIDGE ST, OSWEGO, NY 13126-2051
(315) 343-5722
Mailing address
24 W BRIDGE ST, OSWEGO, NY 13126-2051
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
19649
NY
3336C0004X
Compounding Pharmacy
19649
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01252657
—
NY
Enumeration date
05/25/2007
Last updated
07/18/2007
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