MEDICARE: ALFRED PHARMACY 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
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	019532	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2064294	OTHER		PK

General Provider Information

NPI Number	:	1285746297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALFRED PHARMACY INC

Provider Business Mailing Address
First Line	:	36 N MAIN ST
Second Line	:
City	:	ALFRED
State	:	NY
Zip	:	14802-1011
Country	:	US
Telephone Number	:	607-587-9222
Fax Number	:	607-587-9629

Provider Business Practice Location Address
First Line	:	36 N MAIN ST
Second Line	:
City	:	ALFRED
State	:	NY
Zip	:	14802-1011
Country	:	US
Telephone Number	:	607-587-9222
Fax Number	:	607-587-9629

Authorized Official
Title or Position	:	OWNER
Name	:	ANTHONY GRAZIANO
Credential	:	RPH
Telephone Number	:	607-587-9222

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	05/01/2017

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Directions to “ALFRED PHARMACY INC ” Practice Location

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