MEDICARE: HAMMECKER PHARMACIES INC.

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	3336C0003X	Community/Retail Pharmacy	019592	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

General Provider Information

NPI Number	:	1417099292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMMECKER PHARMACIES INC.

Provider Business Mailing Address
First Line	:	6805 MCALPINE STREET
Second Line	:
City	:	LYONS FALLS
State	:	NY
Zip	:	13368-0265
Country	:	US
Telephone Number	:	348-348-8121
Fax Number	:	315-348-6120

Provider Business Practice Location Address
First Line	:	6805 MCALPINE STREET
Second Line	:
City	:	LYONS FALLS
State	:	NY
Zip	:	13368-0265
Country	:	US
Telephone Number	:	315-348-8121
Fax Number	:	315-348-6120

Authorized Official
Title or Position	:	PHARMACIST/OWNER
Name	:	LORI FARQUHAR
Credential	:
Telephone Number	:	315-348-8121

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	04/16/2015

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