Organization
ABBOTT PHARMACY, INC.
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
CYRUS ARDALAN (OWNER)
(716) 796-5668
Entity
Organization
Contact information
Practice address
1979 SENECA ST, BUFFALO, NY 14210-2352
(716) 822-4400
Mailing address
3038 BAILEY AVE, BUFFALO, NY 14215-2814
(716) 822-4400
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
030656
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5802598
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/10/2011
Last updated
01/06/2014
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