Organization
PERU PHARMACY INC.
Active
Other names
Peru Healthmart Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE KENNETH SHANLEY PHARM D (SUPERVISING PHARMACIST/MANAGER)
(518) 643-2318
Entity
Organization
Contact information
Practice address
3 GORMAN WAY, PERU, NY 12972-3060
(518) 643-2318
(518) 643-0010
Mailing address
PO BOX 86, PERU, NY 12972-0086
(518) 643-2318
(518) 643-0010
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
026013-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00619172
—
NY
01
—
3342499
NABP
NY
Enumeration date
09/20/2006
Last updated
06/03/2014
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