Organization
PINE PHARMACY AND HOME CARE PRODUCTS CENTER INC
Active
Other names
PINE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALFONSE MUTO RPH (PRESIDENT/OWNER)
(716) 282-1112
Entity
Organization
Contact information
Practice address
5110 MAIN ST, WILLIAMSVILLE, NY 14221-5256
(716) 332-2288
(716) 332-2287
Mailing address
5110 MAIN ST, WILLIAMSVILLE, NY 14221-5256
(716) 332-2288
(716) 332-2287
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
026390
NY
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2062651
PK
—
05
—
2864482
—
NY
Enumeration date
09/12/2006
Last updated
05/18/2016
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