A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally...
ID license #1907CPtaxonomy 333600000X
Identifiers
Type
Value
Notes
01 (ID)
1300514/8L386
BLUE CROSS
05 (ID)
807034200
05 (ID)
807071700
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
Pharmacy Shop
Type code 3recorded 2005-08-02
Practice context
Multi-provider organization.
1 individual provider on file at this primary address.
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