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Organization

CRYSTAL CITY APOTHECARY LLC

Active
Other names
Waverly Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DONALD W GUTHRIE ROBERT PACKER HOSPITAL RPH (MEMBER)
(160) 756-5239
Entity
Organization

Contact information

Practice address
443 CAYUTA AVE, WAVERLY, NY 14892-1506
(607) 565-2390
(607) 565-2393
Mailing address
443 CAYUTA AVE, WAVERLY, NY 14892-1506
(607) 565-2390
(607) 565-2393

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary

Other

Enumeration date
10/10/2023
Last updated
10/10/2023
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