Provider Demographics
NPI:1891786125
Name:MONAHAN AND BROSWSKI PHARMACISTS LTD
Entity Type:Organization
Organization Name:MONAHAN AND BROSWSKI PHARMACISTS LTD
Other - Org Name:THORPE'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ PHARMACISTD
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:MONAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-686-5711
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:HOOSICK FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12090-0217
Mailing Address - Country:US
Mailing Address - Phone:518-686-5711
Mailing Address - Fax:518-686-1706
Practice Address - Street 1:24 CHURCH ST
Practice Address - Street 2:
Practice Address - City:HOOSICK FALLS
Practice Address - State:NY
Practice Address - Zip Code:12090-1600
Practice Address - Country:US
Practice Address - Phone:518-686-5711
Practice Address - Fax:518-686-1706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030544-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00814466Medicaid
NY00814466Medicaid