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Organization

AUBURN CORRECTIONAL FCLTY-PHCY

Active
Other names
AUBURN CORRECTIONAL FACILITY PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
GRACE ELLEGATE (SUPERVISING RPH III)
(315) 253-8401
Entity
Organization

Contact information

Practice address
135 STATE ST, AUBURN, NY 13024-9001
(315) 253-8401
(315) 255-1371
Mailing address
135 STATE ST, AUBURN, NY 13024-9001
(315) 253-8401
(315) 255-1371

Taxonomy

Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
010267
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2062691
PK
Enumeration date
09/22/2014
Last updated
09/22/2014
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