Organization
ADDISON'S APOTHECARY INC.
Active
Other names
Green Street Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE PAGANO PHARMD (CO-OWNER)
(607) 882-9500
Entity
Organization
Contact information
Practice address
131 EAST GREEN STREET, SUITE 2, ITHACA, NY 14850-5661
(607) 882-9500
(607) 882-9503
Mailing address
131 EAST GREEN STREET, SUITE 2, ITHACA, NY 14850-5661
(607) 882-9500
(607) 882-9503
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03454464
—
NY
Enumeration date
11/08/2011
Last updated
01/16/2013
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