Organization
JNR PHARMACY BREWSTER INC
Active
Other names
JNR PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SRI TALLA (PHARMACIST)
(845) 392-8254
Entity
Organization
Contact information
Practice address
2505 CARMEL AVE STE 110-111, BREWSTER, NY 10509-1155
(845) 278-8200
(845) 278-4340
Mailing address
2505 CARMEL AVE STE 111, BREWSTER, NY 10509-1156
(845) 278-8200
(845) 278-4340
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
030737
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130592
PK
—
05
—
3333355
—
NY
Enumeration date
04/11/2011
Last updated
04/25/2016
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