Organization
SMITH STREET PHARMACY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY DITTENHOEFER (OWNER/PHARMACIST)
(845) 471-6440
Entity
Organization
Contact information
Practice address
269 MANSION ST, POUGHKEEPSIE, NY 12601-2623
(845) 471-6440
(845) 471-7258
Mailing address
269 MANSION ST, POUGHKEEPSIE, NY 12601-2623
(845) 471-6440
(845) 471-7258
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
025253
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02254240
—
NY
Enumeration date
09/21/2006
Last updated
03/07/2023
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