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General NPI Number Information
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NPI Number | 1083157036
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Entity Type | Organization
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Legal Business Name | ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO NY LLC
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Dates
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Enumeration Date | 11/23/2016
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 140 JOHN JAMES AUDUBON PKWY STE 101
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City | AMHERST
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State | NY
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Zip | 14228-1183
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Country | US
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Telephone | 877-662-6633
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Fax | 877-662-6355
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Provider Business Mailing Address
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Address Line | 13410 EASTPOINT CENTRE DR STE 100
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City | LOUISVILLE
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State | KY
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Zip | 40223-4160
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Country | US
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Telephone | 877-662-6633
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Fax | 502-849-0643
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Authorized Official
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Title or Position | VP, REIMBURSEMENT REVENUE CYCLE MGT
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Name | AMY KONAK
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Credential |
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Telephone | 877-662-6633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 030717
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License Number State | NY
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