New York State Department of Health, Wadsworth Center
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CVS Pharmacy No. 05104
PFI: F361 Secondary Site ID: 0000 Certification Type: WAIVER Director: Ray M King, Pharm.D. Phone: (631) 399-0324 Fax: (401) 652-9541 Address: 496 County Rd 111 - Bldg C, Manorville, NY 11949 County: Suffolk Country: United States Single or Primary Contact: Maria Medeiros Contact Phone: (401) 770-1610 CLIA #: 33D2261646
PFI: F362 Secondary Site ID: 0000 Certification Type: WAIVER Director: Sara T Martin, Pharm.D. Phone: (716) 648-1610 Fax: (401) 652-9541 Address: 7182 Boston State Rd, Hamburg, NY 14075 County: Erie Country: United States Single or Primary Contact: Maria Medeiros Contact Phone: (401) 770-1610 CLIA #: 33D2261645
PFI: F365 Secondary Site ID: 0000 Certification Type: WAIVER Director: Michael D Panko, Pharm.D. Phone: (845) 534-2506 Fax: (401) 652-9541 Address: 65 Quaker Ave, Cornwall, NY 12518 County: Orange Country: United States Single or Primary Contact: Maria Medeiros Contact Phone: (401) 770-1610 CLIA #: 33D2261641
PFI: F373 Secondary Site ID: 0000 Certification Type: WAIVER Director: Bei V Guo,RPh Phone: (718) 975-0530 Fax: (718) 975-0531 Address: 2173C 68th St, Brooklyn, NY 11204 County: Kings Country: United States Single or Primary Contact: Contact Phone: CLIA #: 33D2263243
PFI: F377 Secondary Site ID: 0000 Certification Type: WAIVER Director: Katherine P Mullins, M.D. Phone: (718) 210-5293 Fax: (718) 599-2840 Address: 317 Bowery, New York, NY 10003 County: New York Country: United States Single or Primary Contact: Olivia Alcantara Contact Phone: (718) 302-7320 CLIA #: 33D2265897
PFI: F380 Secondary Site ID: 0000 Certification Type: WAIVER Director: Katherine P Mullins, M.D. Phone: (347) 377-4243 Fax: (929) 455-9267 Address: 64 Sunken Garden Loop, New York, NY 10035 County: New York Country: United States Single or Primary Contact: Olivia Alcantara Contact Phone: (718) 302-7320 CLIA #: 33D2265905
PFI: F382 Secondary Site ID: 0000 Certification Type: WAIVER Director: Ashley Comfort, M.D. Phone: (646) 889-2211 Fax: (917) 475-1014 Address: 202 Spring St - 2nd Fl, New York, NY 10012 County: New York Country: United States Single or Primary Contact: Adrienne Smith Contact Phone: (561) 275-8953 CLIA #: 33D2262515
PFI: F383 Secondary Site ID: 0000 Certification Type: PPMP Director: Evelyn Chu, M.D. Phone: (888) 663-6331 Fax: (212) 867-4353 Address: 48 W 30th St, 2nd Floor, New York, NY 10001 County: New York Country: United States Single or Primary Contact: Laura Schmiess Contact Phone: (415) 658-6791 CLIA #: 33D2262513