Provider Demographics
NPI:1871228924
Name:CMV PHARMACY INC
Entity type:Organization
Organization Name:CMV PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:COLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-323-1303
Mailing Address - Street 1:1017 MADISON MARKETPLACE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NY
Mailing Address - Zip Code:13346-2343
Mailing Address - Country:US
Mailing Address - Phone:315-825-9800
Mailing Address - Fax:
Practice Address - Street 1:1017 MADISON MARKETPLACE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NY
Practice Address - Zip Code:13346-2343
Practice Address - Country:US
Practice Address - Phone:315-825-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY035151OtherSTATE LICENSE