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General NPI Number Information
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NPI Number | 1467566448
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Entity Type | Organization
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Legal Business Name | NICKEL CITY PHARMACY INC
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 1791 S PARK AVE
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City | BUFFALO
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State | NY
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Zip | 14220-1411
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Country | US
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Telephone | 716-823-8300
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Fax | 716-823-8301
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Provider Business Mailing Address
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Address Line | 1791 S PARK AVE
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City | BUFFALO
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State | NY
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Zip | 14220-1411
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Country | US
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Telephone | 716-823-8300
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Fax | 716-823-8301
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Authorized Official
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Title or Position | MANAGER
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Name | CYRUS ARDALAN
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Credential | RPH
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Telephone | 716-824-5200
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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 | 027834
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License Number State | NY
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