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General NPI Number Information
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NPI Number | 1720183700
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Entity Type | Organization
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Legal Business Name | MARIAN MEDICAL PHARMACY INC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 02/02/2011
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Provider Practice Location Address
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Address Line | 515 ABBOTT RD
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City | BUFFALO
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State | NY
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Zip | 14220-1700
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Country | US
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Telephone | 716-823-7374
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Fax |
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Provider Business Mailing Address
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Address Line | 515 ABBOTT RD
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City | BUFFALO
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State | NY
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Zip | 14220-1700
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Country | US
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Telephone | 716-823-7374
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES NOTARO
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Credential | RPH
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Telephone | 716-823-7374
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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 | 021336
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License Number State | NY
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