Organization
TACONIC PHARMACY INC
Active
Other names
TACONIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY JOHN CIARLETTA R.PH. (VICE PRESIDENT)
(914) 245-3334
Entity
Organization
Contact information
Practice address
3659 LEE RD, JEFFERSON VALLEY, NY 10535-1507
(914) 245-3334
(914) 245-4096
Mailing address
3659 LEE RD, JEFFERSON VALLEY, NY 10535-1507
(914) 245-3334
(914) 245-4096
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030654
NYS BOARD LICENSE NUMBER
NY
05
—
03351622
—
NY
Enumeration date
06/20/2024
Last updated
06/20/2024
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