Healthcare Provider Details

I. General information

NPI: 1740415538
Provider Name (Legal Business Name): JENNIFER KILMER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2009
Last Update Date: 05/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6344 TRANSIT RD
DEPEW NY
14043-1031
US

IV. Provider business mailing address

5200 FOX TRCE
WILLIAMSVILLE NY
14221-4167
US

V. Phone/Fax

Practice location:
  • Phone: 716-683-9444
  • Fax: 716-683-9425
Mailing address:
  • Phone: 716-683-9444
  • Fax: 716-683-9425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number050360
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: