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General NPI Number Information
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NPI Number | 1407386873
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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 | 06/18/2017
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Last Update Date | 06/18/2017
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Provider Practice Location Address
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Address Line | 2157 MAIN ST
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City | BUFFALO
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State | NY
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Zip | 14214-2648
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Country | US
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Telephone | 716-359-3121
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Fax |
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Provider Business Mailing Address
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Address Line | 144 GENESEE ST FL 2
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City | BUFFALO
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State | NY
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Zip | 14203-1560
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Country | US
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Telephone | 716-359-3121
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Fax |
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST
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Name | GREGORY BLETTE
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Credential | PHARMD
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Telephone | 716-359-3121
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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 | 035500
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License Number State | NY
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