Kmart Pharmacy Corporation LLC
Organization Active NPI Pharmacy · Sidney, NY
NPI 1639613607 · NPPES record last updated Dec 11, 2016
Key facts
- NPI
- 1639613607
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- I062177 (NY)
- Legal business name
- KMART PHARMACY CORPORATION LLC
- Practice address
- 171 Delaware Ave
Sidney, NY 13838-1349 - Phone
- (607) 563-9911
- Fax
- (607) 563-7004
- NPI assigned
- Dec 11, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Lynda Davidson, PHARMD
- Title
- District Manager
- Phone
- (716) 982-1609
National Provider Directory
Locations
171 Delaware Ave
Sidney, NY 13838
Phone (607) 563-9911
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | I062177 | NY | Yes |
Addresses
Primary practice location
171 Delaware Ave
Sidney, NY 13838-1349
Mailing address
171 Delaware Ave
Sidney, NY 13838-1349
Phone (607) 563-9911
Other providers in Sidney, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.