Organization
FISHKILL PLAINS PHARMACY INC
Active
Other names
MEDICAP PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH BALASIANO RPH. (PRES)
(845) 897-0636
Entity
Organization
Contact information
Practice address
1004 MAIN ST, BLDG 554, FISHKILL, NY 12524-3509
(845) 897-0636
(845) 897-0638
Mailing address
1004 MAIN ST, BLDG 554, FISHKILL, NY 12524-3509
(845) 897-0636
(845) 897-0638
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
026853
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02619950
—
NY
01
—
3339050
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/03/2006
Last updated
01/03/2013
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