Provider Demographics
NPI:1629592001
Name:DOLSONTOWN PHARMACY CORP.
Entity Type:Organization
Organization Name:DOLSONTOWN PHARMACY CORP.
Other - Org Name:DOLSONTOWN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PRATA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:914-224-6890
Mailing Address - Street 1:6 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-6411
Mailing Address - Country:US
Mailing Address - Phone:914-224-6890
Mailing Address - Fax:845-775-4185
Practice Address - Street 1:1291 DOLSONTOWN RD STE 2
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-4772
Practice Address - Country:US
Practice Address - Phone:845-775-4175
Practice Address - Fax:845-775-4185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-27
Last Update Date:2017-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035557333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy