Kmart Pharmacy Corporation LLC

NPI #1639613607 in Sidney, New York

Provider Information

NPI Number: 1639613607
Entity Type: Organization
Organization Name: Kmart Pharmacy Corporation LLC
Primary Specialty: Pharmacy
Enumeration Date: Dec 11, 2016
Last Updated: Dec 11, 2016

Practice Location

Address: 171 DELAWARE AVE
City: Sidney
State: New York
ZIP Code: 13838-1349
Phone: (607) 563-9911

Authorized Official

Name: DR. LYNDA DAVIDSON, PHARMD
Title: DISTRICT MANAGER
Phone: (716) 982-1609

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy	333600000X	Primary

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