Organization
MOLLOY MEDICAL ARTS PHARMA INC
Active
Other names
MOLLOY MEDICAL ARTS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GANESH KRISHNACHAND TALASILA (PHARMACY MANAGER)
(845) 471-7455
Entity
Organization
Contact information
Practice address
19 BAKER AVE STE 207, STE 207, POUGHKEEPSIE, NY 12601-1375
(845) 471-7455
(845) 473-6337
Mailing address
19 BAKER AVE, STE 207, POUGHKEEPSIE, NY 12601
(845) 471-7455
(845) 473-6337
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
031697
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03498666
—
NY
01
—
2139794
PK
—
Enumeration date
10/02/2012
Last updated
01/26/2022
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