Healthcare Provider Details

I. General information

NPI: 1164603411
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: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 W 26TH ST
ERIE PA
16508-1302
US

IV. Provider business mailing address

PO BOX 1027
BUFFALO NY
14240-1027
US

V. Phone/Fax

Practice location:
  • Phone: 814-455-9500
  • Fax: 855-331-9347
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 NumberPP415114L
License Number StatePA

VIII. Authorized Official

Name: MATT HAMED
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 716-635-5274