=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538561527
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAV-RITE PHARMACY, LLC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/22/2014
-----------------------------------------------------
Last Update Date | 01/26/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 290 CENTER RD
-----------------------------------------------------
City | WEST SENECA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14224-1945
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-675-0000
-----------------------------------------------------
Fax | 716-677-0757
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 290 CENTER RD
-----------------------------------------------------
City | WEST SENECA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14224-1945
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-675-0000
-----------------------------------------------------
Fax | 716-677-0757
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | AKRAM MONSSAR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 716-675-0000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 032725
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------