Provider Demographics
NPI:1932524808
Name:LOUDONVILLE PHARMACY LLC
Entity Type:Organization
Organization Name:LOUDONVILLE PHARMACY LLC
Other - Org Name:CARE RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:SRINIVASA
Authorized Official - Middle Name:
Authorized Official - Last Name:TALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-512-4545
Mailing Address - Street 1:265 OSBORNE RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12211-1879
Mailing Address - Country:US
Mailing Address - Phone:518-512-4545
Mailing Address - Fax:518-512-4546
Practice Address - Street 1:265 OSBORNE RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12211-1879
Practice Address - Country:US
Practice Address - Phone:518-512-4545
Practice Address - Fax:518-512-4546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032477333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy