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General NPI Number Information
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NPI Number | 1427938349
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Entity Type | Organization
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Legal Business Name | VITAL NIAGARA FALLS LLC
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 2715 HIGHLAND AVE
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City | NIAGARA FALLS
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State | NY
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Zip | 14305-2466
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Country | US
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Telephone | 716-923-4603
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Fax |
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Provider Business Mailing Address
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Address Line | 301 CONNECTICUT ST
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City | BUFFALO
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State | NY
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Zip | 14213-2541
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. JOSEPH BELLAVIA JR.
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Credential | PHARMD
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Telephone | 716-923-4603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 |
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License Number State |
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