Organization
ER BLACK PHARMACY INC
Active
Other names
Holland Patent Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EARL ROBERT BLACK JR. R PH (PRESIDENT PHARMACIST)
(315) 865-8141
Entity
Organization
Contact information
Practice address
9553 MAIN STREET, HOLLAND PATENT, NY 13354-0205
(315) 865-8141
(315) 865-4318
Mailing address
9553 MAIN ST, HOLLAND PATENT, NY 13354
(315) 865-8141
(315) 865-4318
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
024930
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02139724
—
NY
01
—
3332727
NABP #
NY
Enumeration date
01/02/2007
Last updated
11/26/2013
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