| NPI | 1336493014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFRED REIMAN Supervising Pharmacist 716-645-2827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: NY 000021) |
| Additional Taxonomies | 3336S0011X Pharmacy Specialty Pharmacy |
| 333600000X Pharmacy | |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| Enumeration Date | 2012-11-02 |
| Last Update Date | 2016-06-22 |