Organization
MEDWIZ PHARMACY LLC
Active
Other names
MedWiz Pharmacy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC NEWHOUSE (CEO,OWNER,AO)
(845) 558-5390
Entity
Organization
Contact information
Practice address
240 N MAIN ST, SPRING VALLEY, NY 10977-4020
(845) 624-5200
(845) 624-5300
Mailing address
240 N MAIN ST, SPRING VALLEY, NY 10977-4020
(845) 624-5200
(845) 624-5300
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
029312
NY
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04418659
—
NY
01
—
2153610
PK
—
Enumeration date
08/12/2015
Last updated
02/20/2017
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