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General NPI Number Information
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NPI Number | 1194486548
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Entity Type | Organization
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Legal Business Name | VILLAGE PHARMACY OF LOCKPORT, INC.
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Dates
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Enumeration Date | 01/07/2022
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Last Update Date | 01/07/2022
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Provider Practice Location Address
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Address Line | 6478 RIDGE RD
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City | LOCKPORT
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State | NY
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Zip | 14094-1015
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Country | US
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Telephone | 716-302-3434
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Fax | 716-727-3302
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Provider Business Mailing Address
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Address Line | 6478 RIDGE RD
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City | LOCKPORT
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State | NY
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Zip | 14094-1015
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Country | US
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Telephone | 716-302-3434
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Fax | 716-727-3302
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST
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Name | CYRUS ARDALAN
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Credential | RPH
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Telephone | 716-796-5668
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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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