Organization
ELLICOTTVILLE PHARMACY INC
Active
Other names
ELLICOTTVILLE PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN GILROY RPH (PRESIDENT)
(716) 699-2300
Entity
Organization
Contact information
Practice address
6133 ROUTE 219 S, STE 1004, ELLICOTTVILLE, NY 14731-9613
(716) 699-2300
(716) 699-5508
Mailing address
6133 ROUTE 219 S, STE 1004, ELLICOTTVILLE, NY 14731-9613
(716) 699-2300
(716) 699-5508
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
017405
NY
3336L0003X
Long Term Care Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00745102
—
NY
01
—
2060679
PK
—
Enumeration date
07/10/2006
Last updated
10/23/2023
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