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Organization

KMART PHARMACY CORPORATION LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LYNDA DAVIDSON PHARMD (DISTRICT MANAGER)
(716) 982-1609
Entity
Organization

Contact information

Practice address
171 DELAWARE AVE, SIDNEY, NY 13838-1349
(607) 563-9911
(607) 563-7004
Mailing address
171 DELAWARE AVE, SIDNEY, NY 13838-1349
(607) 563-9911
(607) 563-7004

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
I062177
NY

Other

Enumeration date
12/11/2016
Last updated
12/11/2016
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