| NPI | 1013495423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN T WACLAWEK COO 716-876-2323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: NY 036719) |
| Additional Taxonomies | 3336S0011X Pharmacy Specialty Pharmacy |
| 3336I0012X Pharmacy Institutional Pharmacy | |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2024-08-07 |