Organization
BLACK ROCK PHARMACY INC
Active
Other names
BLACKROCK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY ARTHUR RPH (PRESIDENT)
(716) 876-3070
Entity
Organization
Contact information
Practice address
431 TONAWANDA ST, BUFFALO, NY 14207-2625
(716) 876-3070
(716) 876-7464
Mailing address
431 TONAWANDA ST, BUFFALO, NY 14207-2625
(716) 876-3070
(716) 876-7464
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
014228
NY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00591864
—
NY
01
—
2059333
PK
—
Enumeration date
05/26/2006
Last updated
11/01/2016
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