Organization
P D L DRUG STORE INC
Active
Other names
Whites Drug and Department Store
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DERYN TROTT (VICE PRESIDENT)
(631) 668-2994
Entity
Organization
Contact information
Practice address
95 THE PLZ, MONTAUK, NY 11954-4000
(631) 668-2994
(631) 668-1109
Mailing address
PO BOX 940, MONTAUK, NY 11954-0740
(631) 668-2994
(631) 668-1109
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
016022
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01425814
—
NY
01
—
016022
STATE LIC. NUMBER
NY
Enumeration date
03/07/2007
Last updated
07/15/2024
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