Organization
WOODMARK PHARMACY OF NEW YORK, LLC
Active
Other names
Woodmark Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT KRUSE RPH (DIRECTOR)
(716) 260-6936
Entity
Organization
Contact information
Practice address
1142 WEHRLE DR, WILLIAMSVILLE, NY 14221-7748
(716) 631-3381
Mailing address
641 LEXINGTON AVE, 31ST FLOOR, NEW YORK, NY 10022-4503
(212) 802-7609
(646) 924-0520
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
031869
NY
3336L0003X
Long Term Care Pharmacy
Primary
031869
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6864720001
MEDICARE PTAN
NY
Enumeration date
01/29/2013
Last updated
08/24/2016
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