Organization
DEDALE PHARMACY INC
Active
Other names
DALE DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT DEVIVO RPH (PRES)
(516) 561-1222
Entity
Organization
Contact information
Practice address
531 W MERRICK RD, VALLEY STREAM, NY 11580-5125
(516) 561-1222
(516) 561-1223
Mailing address
531 W MERRICK RD, VALLEY STREAM, NY 11580-5125
(516) 561-1222
(516) 561-1223
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
022517
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01554829
—
NY
01
—
2057449
PK
—
Enumeration date
02/27/2007
Last updated
08/31/2016
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