Provider Demographics
NPI:1881650620
Name:G. & L. DRUG, INC.
Entity Type:Organization
Organization Name:G. & L. DRUG, INC.
Other - Org Name:HARRISON CENTER PHARMACY- LEADER/KRESS DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:STANTON
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH,
Authorized Official - Phone:315-476-4074
Mailing Address - Street 1:LEADER/ KRESS DRUGS -HARRISON CENTER PHARMACY
Mailing Address - Street 2:550 HARRISON CENTER
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-3096
Mailing Address - Country:US
Mailing Address - Phone:315-476-4074
Mailing Address - Fax:315-476-1344
Practice Address - Street 1:LEADER/ KRESS DRUGS -HARRISON CENTER PHARMACY
Practice Address - Street 2:550 HARRISON CENTER
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3096
Practice Address - Country:US
Practice Address - Phone:315-476-4074
Practice Address - Fax:315-476-1344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013555NY183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00493201Medicaid