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Organization
UPSTATE PHARMACY LTD
Active
Organization
UPSTATE PHARMACY LTD
Active
Other names
UPSTATE PHARMACY LTD
Organization subpart
No
Provider details
NPI number
Authorized official
TED KUZNIRREK RPH (VP)
(716) 675-3794
Entity
Organization
Contact information
Practice address
1900 N AMERICA DR STE 100, STE 100, WEST SENECA, NY 14224-2014
(716) 675-3784
(716) 675-7777
Mailing address
1900 NORTH AMERICA DR, STE 100, WEST SENECA, NY 14224-2014
(716) 675-3784
(716) 675-7777
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
023581
NY
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01820933
—
NY
01
—
2062950
PK
—
Enumeration date
08/31/2006
Last updated
05/01/2019
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