Provider Demographics
NPI:1285797894
Name:FEEK PHARMACY INC
Entity type:Organization
Organization Name:FEEK PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GODLEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:518-647-8484
Mailing Address - Street 1:14223 NYS RTE 9N
Mailing Address - Street 2:
Mailing Address - City:AU SABLE FORKS
Mailing Address - State:NY
Mailing Address - Zip Code:12912-0087
Mailing Address - Country:US
Mailing Address - Phone:518-647-8484
Mailing Address - Fax:518-647-1223
Practice Address - Street 1:14223 NYS RTE 9N
Practice Address - Street 2:
Practice Address - City:AU SABLE FORKS
Practice Address - State:NY
Practice Address - Zip Code:12912-0087
Practice Address - Country:US
Practice Address - Phone:518-647-8484
Practice Address - Fax:518-647-1223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0121243336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00585988Medicaid
0862210001Medicare ID - Type Unspecified