Healthcare Provider Details

I. General information

NPI: 1821279167
Provider Name (Legal Business Name): TOPS MARKETS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 05/09/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

890 YOUNG ST
TONAWANDA NY
14150-4114
US

IV. Provider business mailing address

PO BOX 1027
BUFFALO NY
14240-1027
US

V. Phone/Fax

Practice location:
  • Phone: 716-692-8286
  • Fax: 855-331-9032
Mailing address:
  • Phone: 716-635-5276
  • Fax: 716-635-5992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number024913
License Number StateNY

VIII. Authorized Official

Name: JOHN PERSONS
Title or Position: PRESIDENT, DIRECTOR
Credential:
Phone: 716-635-5274