| 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 |