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A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Clinic Pharmacy |
3336C0002X | 58 | Medical Supply Company with Pharmacist | |
Community/Retail Pharmacy |
3336C0003X | 58 | Medical Supply Company with Pharmacist | |
Pharmacy |
333600000X | 58 | Medical Supply Company with Pharmacist |
| NPI # | 1801991757 |
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| LBN Legal business name | INDEPENDENT COMMUNITY PHARMACY INC | ||||||||||||
| Authorized official | VICTOR KOBLIN - (PRESIDENT) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 09/14/2006 | ||||||||||||
| Last updated | 09/11/2025 - About 9 months ago | ||||||||||||
| Identifiers |
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INDEPENDENT COMMUNITY PHARMACY INC