Organization
MIRRA RX INC
Active
Other names
Cornerstone Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY DOMINICK MIRRA RPH (PRESIDENT)
(914) 980-8321
Entity
Organization
Contact information
Practice address
14 MADISON AVE, VALHALLA, NY 10595-1900
(800) 361-1260
Mailing address
14 MADISON AVE, VALHALLA, NY 10595-1900
(800) 361-1260
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
030332
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030332
NYS PHARMACY REGISTRATION
NY
Enumeration date
12/14/2010
Last updated
07/10/2013
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