Organization
CHC PHARMACY LLC
Active
Other names
CORTLAND LEADER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY FULLER RPH (PIC)
(607) 756-4686
Entity
Organization
Contact information
Practice address
1259 FISHER AVE, CORTLAND, NY 13045-1012
(607) 756-4686
(607) 756-1717
Mailing address
1259 FISHER AVE, CORTLAND, NY 13045-1012
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
025067
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02513766
—
NY
01
—
3323247
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/17/2006
Last updated
02/19/2008
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