Provider Demographics
NPI:1104399609
Name:MCCANN DRUG CO INC
Entity type:Organization
Organization Name:MCCANN DRUG CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-747-4732
Mailing Address - Street 1:166 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12839-1846
Mailing Address - Country:US
Mailing Address - Phone:518-747-4732
Mailing Address - Fax:518-747-6667
Practice Address - Street 1:166 MAIN ST
Practice Address - Street 2:
Practice Address - City:HUDSON FALLS
Practice Address - State:NY
Practice Address - Zip Code:12839-1846
Practice Address - Country:US
Practice Address - Phone:518-747-4732
Practice Address - Fax:518-747-6667
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCCANN DRUG CO INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy