Organization
4800 BEAR ROAD OPERATING COMPANY, LLC
Active
Parent organization
4800 BEAR ROAD OPERATING COMPANY, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
4800 BEAR ROAD OPERATING COMPANY, LLC
Authorized official
DR. JEFFREY RUBIN (CO- CHIEF EXECUTIVE OFFICER)
(716) 817-5075
Entity
Organization
Contact information
Practice address
4800 BEAR RD, LIVERPOOL, NY 13088-4604
(315) 457-9946
Mailing address
500 SENECA ST STE 100, BUFFALO, NY 14204-1963
(716) 633-3900
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
031933
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031933
STATE PHARMACY BOARD REGISTRATION
NY
Enumeration date
08/16/2013
Last updated
01/19/2023
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