MEDICARE: TOPS MARKETS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	018483	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2069884	OTHER		PK

General Provider Information

NPI Number	:	1386825628
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOPS MARKETS LLC

Provider Business Mailing Address
First Line	:	PO BOX 1027
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14240-1027
Country	:	US
Telephone Number	:	716-635-5276
Fax Number	:	716-635-5992

Provider Business Practice Location Address
First Line	:	2351 MAPLE RD
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14221-4038
Country	:	US
Telephone Number	:	716-515-3205
Fax Number	:	855-331-9021

Authorized Official
Title or Position	:	DIRECTOR OF PHARMACY
Name	:	MATT HAMED
Credential	:
Telephone Number	:	716-635-5274

Provider Enumeration Date	:	11/15/2007
Last Update Date	:	07/19/2018

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Directions to “TOPS MARKETS LLC ” Practice Location

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