Provider Information for 1497857114
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CHARLIE'S FAMILY PHARMACY INC
Organization Subpart: NO
NPI: 1497857114
Last Updated: 2008-02-19
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1497857114 | ||||||||
| Enumeration Date | 2006-09-02 | ||||||||
| NPI Type | NPI-2 Organization | ||||||||
| Status | Active | ||||||||
| Authorized Official Information | Name: CHARLES LAQUIDARA Title: Owner/Pharmacist Phone: 5167837979 | ||||||||
| Mailing Address | 3931 MERRICK RD SEAFORD, NY 11783-2823 United States Phone: 516-783-7979 | Fax:516-783-6261 | ||||||||
| Primary Practice Address | 3931 MERRICK RD SEAFORD, NY 11783-2823 United States Phone: 516-783-7979 | Fax:516-783-6261 | ||||||||
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