Provider Demographics
NPI:1881333870
Name:THE APOTHECARY LAB INC
Entity type:Organization
Organization Name:THE APOTHECARY LAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHKOLNIK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:917-669-8791
Mailing Address - Street 1:20 DEPOT ST UNIT 40
Mailing Address - Street 2:
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-1453
Mailing Address - Country:US
Mailing Address - Phone:603-924-2994
Mailing Address - Fax:
Practice Address - Street 1:20 DEPOT ST UNIT 40
Practice Address - Street 2:
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-1453
Practice Address - Country:US
Practice Address - Phone:603-924-2994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy