Organization
COSTCO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARD KANCHUGAR (RPH)
(845) 364-4219
Entity
Organization
Contact information
Practice address
50 OVERLOOK BLVD, NANUET, NY 10954-5290
(845) 364-4219
(845) 425-2679
Mailing address
2 CHIPPEWA CT, SUFFERN, NY 10901-4111
(845) 357-1449
(845) 425-2679
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
019962
NY
Other
Enumeration date
11/24/2014
Last updated
11/24/2014
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