Provider Demographics
NPI:1922492933
Name:LANGDONS APOTHECARY INC
Entity Type:Organization
Organization Name:LANGDONS APOTHECARY INC
Other - Org Name:LANGDON'S APOTHECARY, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-768-0900
Mailing Address - Street 1:100 MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WHITESBORO
Mailing Address - State:NY
Mailing Address - Zip Code:13492-1027
Mailing Address - Country:US
Mailing Address - Phone:315-768-0900
Mailing Address - Fax:315-768-0909
Practice Address - Street 1:100 MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:WHITESBORO
Practice Address - State:NY
Practice Address - Zip Code:13492-1027
Practice Address - Country:US
Practice Address - Phone:315-768-0900
Practice Address - Fax:315-768-0909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-27
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2151044OtherPK