Organization
BREWERTON PHARMACY INC
Active
Other names
BREWERTON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS CHERVINSKY RPH (PRESIDENT)
(315) 676-4441
Entity
Organization
Contact information
Practice address
9679 BREWERTON RD, BREWERTON, NY 13029-8738
(315) 676-4441
(315) 676-5255
Mailing address
9679 BREWERTON RD, BREWERTON, NY 13029-8738
(315) 676-4441
(315) 676-5255
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
019361
NY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00580149
—
NY
01
—
2062896
PK
—
Enumeration date
09/12/2006
Last updated
03/29/2016
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