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Organization

OLD COUNTRY PHARMACY INC.

Active
Other names
PARKSIDE PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
MR. NEIL C DUBON RPH (SUPERVISING PHARMACIST)
(516) 270-3965
Entity
Organization

Contact information

Practice address
601 OLD COUNTRY RD, WESTBURY, NY 11590-4511
(516) 270-3965
(516) 502-6238
Mailing address
601 OLD COUNTRY RD, WESTBURY, NY 11590-4511
(516) 270-3965
(516) 502-6238

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
027854
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02808919
NY
Enumeration date
07/05/2007
Last updated
08/22/2020
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