Organization
JILLSCOTT CORP
Active
Other names
PARK CHEMISTS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK DELLISANTI RPH (OWNER)
(631) 667-2484
Entity
Organization
Contact information
Practice address
54 DEER SHORE SQ, NORTH BABYLON, NY 11703-1207
(631) 667-2484
(631) 667-8887
Mailing address
54 DEER SHORE SQ, NORTH BABYLON, NY 11703-1207
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
15487
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00461629
—
NY
01
—
3349809
OTHER ID NUMBER
—
Enumeration date
05/13/2006
Last updated
09/13/2007
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