Provider Information for 1013495423
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
PARKVIEW NIAGARA STREET, LLC
Other Names:Doing Business As:RIVERVIEW PROFESSIONAL PHARMACYOrganization Subpart: NO
NPI: 1013495423
Last Updated: 2024-08-07
Certification Date: 2024-08-07
Certification Date: 2024-08-07
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1013495423 | ||||||||||||||||
| Enumeration Date | 2018-07-30 | ||||||||||||||||
| NPI Type | NPI-2 Organization | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Authorized Official Information | Name: Mr. JUSTIN T WACLAWEK PharmD Title: COO Phone: 7168762323 | ||||||||||||||||
| Mailing Address | 3920 MAIN ST STE 150 AMHERST, NY 14226-3350 United States Phone: 716-423-2313 | Fax:716-423-2329 | ||||||||||||||||
| Primary Practice Address | 3920 MAIN ST STE 150 AMHERST, NY 14226-3350 United States Phone: 716-423-2313 | Fax:716-423-2329 | ||||||||||||||||
| Secondary Practice Address(es) | |||||||||||||||||
| Health Information Exchange |
| ||||||||||||||||
| Other Identifiers |
| ||||||||||||||||
| Taxonomy |
|