MEDICARE: JUSTIN SAUL TAYLOR PHARM D

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	183500000X	Pharmacist	066308	NY

General Provider Information

NPI Number	:	1912665068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN SAUL TAYLOR PHARM D

Provider Business Mailing Address
First Line	:	1066 PIONEER DR
Second Line	:
City	:	NORTH TONAWANDA
State	:	NY
Zip	:	14120-2928
Country	:	US
Telephone Number	:	716-628-9002
Fax Number	:

Provider Business Practice Location Address
First Line	:	2578 NIAGARA FALLS BLVD
Second Line	:
City	:	NIAGARA FALLS
State	:	NY
Zip	:	14304-4681
Country	:	US
Telephone Number	:	716-731-3500
Fax Number	:	716-731-3501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2021
Last Update Date	:	06/06/2024

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