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A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Long Term Care Pharmacy |
3336L0003X | 58 | Medical Supply Company with Pharmacist | |
Community/Retail Pharmacy |
3336C0003X | 58 | Medical Supply Company with Pharmacist |
| NPI # | 1699612226 |
| LBN Legal business name | 175 MAIN STREET PHARMACY LLC |
| Authorized official | SANDRA JAMRON - (MANAGER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 05/01/2026 |
| Last updated | 05/05/2026 - About a month ago |
| Identifiers | n/a |
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175 MAIN STREET PHARMACY LLC