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General NPI Number Information
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NPI Number | 1629052295
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Entity Type | Organization
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Legal Business Name | METCARE RX PHARMACEUTICAL SERVICES GROUP, LLC
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 462 GRIDER ST SUSSEX STREET ENTRANCE
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City | BUFFALO
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State | NY
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Zip | 14215-3021
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Country | US
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Telephone | 716-332-2866
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Fax |
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Provider Business Mailing Address
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Address Line | 3201 W COMMERCIAL BLVD SUITE 130
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City | FT LAUDERDALE
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State | FL
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Zip | 33309-3440
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Country | US
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Telephone | 954-653-1040
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Fax |
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Authorized Official
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Title or Position | COORDINATOR OF AMBULATORY CARE SERV
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Name | DR. CORI WYMAN
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Credential | PHARM.D.
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Telephone | 716-332-2866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State |
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