Organization
PHELPS HOMETOWN PHARMACY LLC
Active
Other names
Phelps Hometown Pharmacy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TONI TOMPKINS (SUPERVISING PHARMACIST)
(315) 548-9454
Entity
Organization
Contact information
Practice address
110 MAIN ST, PHELPS, NY 14532-1017
(315) 548-9454
(315) 548-5224
Mailing address
110 MAIN ST, PHELPS, NY 14532-1017
(315) 548-9454
(315) 548-5224
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
030494
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5801813
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/09/2010
Last updated
06/14/2011
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