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Provider Information for 1124480967


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LARCHMONT PHARMACY LLC

Other Names:  
Doing Business As: 
LARCHMONT PHARMACY

Organization Subpart: NO

NPI: 1124480967
Last Updated: 2016-03-22
Certification Date:

Details

NameValue
NPI1124480967
Enumeration Date2016-03-22
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: Mr. ANTHONY JOHN CIARLETTA R.Ph.
Title: Member
Phone: 9143411900
Mailing Address 2141 PALMER AVE
LARCHMONT, NY 10538-2406
United States

Phone: 914-341-1900 | Fax:914-341-1901
 
Primary Practice Address 2141 PALMER AVE
LARCHMONT, NY 10538-2406
United States

Phone: 914-341-1900 | Fax:914-341-1901
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)NY034528NEW YORK STATE BOARD LICENSE NUMBER
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 3336C0003X - Pharmacy - Community/Retail PharmacyNY034528