Organization
VINCE'S PHARMACY OF CAMILLUS INC
Active
Other names
Medicine Shoppe LTC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL MACHEN PHARMD (PRESIDENT)
(315) 487-5775
Entity
Organization
Contact information
Practice address
240 TOWNSHIP BLVD STE 30, CAMILLUS, NY 13031-1793
(315) 487-5775
(315) 487-4423
Mailing address
240 TOWNSHIP BLVD STE 30, CAMILLUS, NY 13031-1793
(315) 487-5775
(315) 487-4423
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00905748
—
NY
01
—
018681
NYS
NY
01
—
0719740001
MEDICARE
NY
Enumeration date
10/26/2022
Last updated
03/07/2023
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