Mr Lawrence Ketrick Shanley, RPH | |
2 Gorman Way, Peru, NY 12972-0086 | |
(518) 643-2318 | |
(518) 643-0010 |
Full Name | Mr Lawrence Ketrick Shanley |
---|---|
Gender | Male |
Speciality | Pharmacist |
Location | 2 Gorman Way, Peru, New York |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548354053 | NPI | - | NPPES |
00619172 | Medicaid | NY | |
3342499 | Other | NY | NCPDP |
016918 | Other | NY | PHARMACY LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
183500000X | Pharmacist | 026013 (New York) | Primary |
Mailing Address | Practice Location Address |
---|---|
Mr Lawrence Ketrick Shanley, RPH 2 Gorman Way, Po Box 86, Peru, NY 12972-0086 Ph: (518) 643-2318 | Mr Lawrence Ketrick Shanley, RPH 2 Gorman Way, Peru, NY 12972-0086 Ph: (518) 643-2318 |
Rachel Connolly, Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 3 Gorman Way, Peru, NY 12972 Phone: 518-643-2318 | |
Lawrence Kenneth Shanley, PHARM. D Pharmacist Medicare: Not Enrolled in Medicare Practice Location: 2940 Main St, Peru, NY 12972 Phone: 518-643-2318 Fax: 518-643-0010 |