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General NPI Number Information
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NPI Number | 1104270206
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Entity Type | Organization
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Legal Business Name | SHERMAN AREA PHARMACY INC
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Dates
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Enumeration Date | 04/15/2016
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Last Update Date | 04/30/2021
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Provider Practice Location Address
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Address Line | 105 W MAIN ST
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City | SHERMAN
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State | NY
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Zip | 14781
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Country | US
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Telephone | 716-761-6876
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Fax | 716-761-6224
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Provider Business Mailing Address
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Address Line | 8629 HIGHLAND AVE
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City | BROCTON
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State | NY
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Zip | 14716-9713
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Country | US
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Telephone | 716-969-4334
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Fax | 716-761-6224
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Authorized Official
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Title or Position | PRESIDENT /OWNER
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Name | CHRISTAN NYWEIDE
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Credential |
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Telephone | 716-969-4334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 34331
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 034331
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License Number State | NY
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