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General NPI Number Information
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NPI Number | 1356588891
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Entity Type | Organization
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Legal Business Name | CATHOLIC HEALTH SYSTEM INFUSION PHARMACY INC
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Dates
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Enumeration Date | 01/20/2009
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Last Update Date | 11/01/2016
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Provider Practice Location Address
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Address Line | 6350 TRANSIT RD
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City | DEPEW
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State | NY
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Zip | 14043-1039
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Country | US
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Telephone | 716-685-4870
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Fax | 716-684-9192
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Provider Business Mailing Address
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Address Line | 6350 TRANSIT RD
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City | DEPEW
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State | NY
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Zip | 14043-1039
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Country | US
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Telephone | 716-685-4870
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Fax | 716-684-9192
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | JOHN RUSSELL
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Credential |
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Telephone | 716-706-2320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | 029376
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License Number State | NY
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Legacy Identifiers
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Identifier #1
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Identifier Code | 3119582
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Identifier Type | MEDICAID
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Identifier State | NY
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Identifier Issuer |
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Identifier #2
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Identifier Code | 2120140
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Identifier Type | OTHER
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Identifier State |
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Identifier Issuer | PK
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 2120140
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Identifier Type | OTHER
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Identifier State |
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Identifier Issuer | PK
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Identifier #2
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Identifier Code | 3119582
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Identifier Type | MEDICAID
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Identifier State | NY
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Identifier Issuer |
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