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NPI Code Detail

MEDICARE: VINCE'S PHARMACY OF CAMILLUS INC

MEDICARE: VINCE'S PHARMACY OF CAMILLUS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
23336L0003XLong Term Care Pharmacy
33336C0003XCommunity/Retail Pharmacy018681NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13384928OTHERNYNCPDP #
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114014164
Entity Type Code : Organization
Provider Name (Legal Business Name) : VINCE'S PHARMACY OF CAMILLUS INC
Provider Business Mailing Address
First Line : 240 TOWNSHIP BLVD STE 30
Second Line :
City : CAMILLUS
State : NY
Zip : 13031-1793
Country : US
Telephone Number : 315-487-5775
Fax Number : 315-487-4423
Provider Business Practice Location Address
First Line : 240 TOWNSHIP BLVD STE 30
Second Line :
City : CAMILLUS
State : NY
Zip : 13031-1793
Country : US
Telephone Number : 315-487-5775
Fax Number : 315-487-4423
Authorized Official
Title or Position : PRESIDENT
Name : DR. MICHAEL MACHEN
Credential : PHARMD
Telephone Number : 315-487-5775
Provider Enumeration Date : 10/09/2006
Last Update Date : 03/07/2023

Similar Medicare Providers

1154032456 — FOCUS VISION DEVELOPMENT OPTOMETRY PLLC
Practice Location Address:
240 TOWNSHIP BLVD STE 60
CAMILLUS, NY
13031-1793
Practice Phone: 315-660-3550
Practice Fax:
1497036875 — DR. MICHAEL MACHEN PHARMD
Practice Location Address:
240 TOWNSHIP BLVD STE 30
CAMILLUS, NY
13031-1793
Practice Phone: 315-487-5775
Practice Fax: 315-487-4423
1962129247 — VINCE'S PHARMACY OF CAMILLUS INC
Practice Location Address:
240 TOWNSHIP BLVD STE 30
CAMILLUS, NY
13031-1793
Practice Phone: 315-487-5775
Practice Fax: 315-487-4423
1003819053 — THOMAS J LACLAIR MD
Practice Location Address:
436 HINSDALE RD
CAMILLUS, NY
13031-1648
Practice Phone: 315-488-0996
Practice Fax: 315-488-1955
1114920287 — DAVID THURBER PAGE MD
Practice Location Address:
436 HINSDALE RD
CAMILLUS, NY
13031-1648
Practice Phone: 315-488-0996
Practice Fax: 315-488-1955
1639172414 — STEVEN M CONNOLLY MD
Practice Location Address:
436 HINSDALE RD
CAMILLUS, NY
13031-1648
Practice Phone: 315-488-0996
Practice Fax: 315-488-1955

Directions to “VINCE'S PHARMACY OF CAMILLUS INC ” Practice Location

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