Healthcare Provider Details

I. General information

NPI: 1568603124
Provider Name (Legal Business Name): VASCUSCRIPT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2009
Last Update Date: 05/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 ELLICOTT ST SUITE 104
BUFFALO NY
14203-1221
US

IV. Provider business mailing address

644 ELLICOTT ST SUITE 104
BUFFALO NY
14203-1221
US

V. Phone/Fax

Practice location:
  • Phone: 716-247-5300
  • Fax: 716-681-2270
Mailing address:
  • Phone: 716-247-5300
  • Fax: 716-681-2270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number029447
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DEAN TRZEWIECZYNSKI
Title or Position: CHIEF OPERATING OFFICER
Credential: B.S. PHARMACY
Phone: 716-247-5300