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Contact Information

JEFFERSON VALLEY PHARMACY INC
3693 HILL BLVD
JEFFERSON VALLEY, NY10535
 Phone: 914-962-6553
 Fax: 914-962-6228
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for JEFFERSON VALLEY PHARMACY INC

NPI Number 1538153200
LBN Legal business name JEFFERSON VALLEY PHARMACY INC
Authorized official DANIEL BECKER - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/08/2005
Last updated 07/21/2022 - About 4 years ago
Identifiers
NY License # 025541
NY Medicaid 02363784
Other 2064827 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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