Organization
DPR EQUITY INC
Active
Other names
The Medicine Shoppe Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MAYUR PATEL (PRESIDENT)
(845) 292-8200
Entity
Organization
Contact information
Practice address
1987 STATE ROUTE 52, STE 3, LIBERTY, NY 12754-8316
(845) 292-8200
(845) 292-9083
Mailing address
1987 STATE ROUTE 52, STE 3, LIBERTY, NY 12754-8316
(845) 292-8200
(845) 292-9083
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
031090
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133701
PK
—
Enumeration date
11/22/2011
Last updated
12/17/2019
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