Healthcare Provider Details

I. General information

NPI: 1194824318
Provider Name (Legal Business Name): ANTHONY-BROWN PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 02/01/2025
Certification Date: 02/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4328 S BUFFALO ST
ORCHARD PARK NY
14127-2638
US

IV. Provider business mailing address

4328 S BUFFALO ST
ORCHARD PARK NY
14127-2638
US

V. Phone/Fax

Practice location:
  • Phone: 716-662-3800
  • Fax: 716-662-3676
Mailing address:
  • Phone: 716-662-3800
  • Fax: 716-662-3676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number010413
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number010413
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number010413
License Number StateNY

VIII. Authorized Official

Name: PATRICK MOOREHEAD
Title or Position: PIC
Credential:
Phone: 716-662-3800