County Line Pharmacy

LBN: P & G Pharmacy Inc
County Line Pharmacy is an health care organization with primary practice located at 1111 Route 110 , Farmingdale NY 11735-4820. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. P & G Pharmacy Inc can be contacted via phone (631) 249-6400, or through Gawrysiak, Richard via phone (631) 249-6400.

Contact Information

Primary practice address
1111 Route 110 Farmingdale NY 11735-4820
Fax: (631) 249-6401
Website:
Authorized official contact:
Name: Gawrysiak, Richard

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 017498 New York

Profile Details

NPI number 1942341805
LBN Legal business name P & G Pharmacy Inc
DBA Doing business as County Line Pharmacy
Authorized official Gawrysiak, Richard
Entity Organization
Organization subpart 1 No
Enumeration date Feb 12th, 2007
Last updated Mar 11th, 2024 - about 8 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942341805 NPPES
Other 2064050 PK
MEDICAID 00717991 PK

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