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Organization
5775 MAELOU DRIVE OPERATING COMPANY, LLC
Active
Organization
5775 MAELOU DRIVE OPERATING COMPANY, LLC
Active
Parent organization
5775 MAELOU DRIVE OPERATING COMPANY, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
5775 MAELOU DRIVE OPERATING COMPANY, LLC
Authorized official
DR. JEFFREY RUBIN (CO-CHIEF EXECUTIVE OFFICER)
(716) 817-5075
Entity
Organization
Contact information
Practice address
5775 MAELOU DR, HAMBURG, NY 14075-7419
(716) 648-2820
Mailing address
500 SENECA ST STE 100, BUFFALO, NY 14204-1963
(716) 633-3900
(646) 924-0520
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031934
NY BOARD OF PHARMACY REGISTRATION
NY
Enumeration date
08/27/2013
Last updated
01/19/2023
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