Organization
GIFFORD & WEST PHARMACY INC
Active
Other names
GIFFORD & WEST PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SAMBASIVA VENIGALLA RPH (PRESIDENT)
(315) 471-4139
Entity
Organization
Contact information
Practice address
300 GIFFORD ST, SYRACUSE, NY 13204-3257
(315) 471-4139
(315) 471-4155
Mailing address
300 GIFFORD ST, SYRACUSE, NY 13204-3257
(315) 471-4139
(315) 471-4155
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
016567
NY
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00572954
—
NY
01
—
2060556
PK
—
Enumeration date
10/04/2006
Last updated
02/20/2017
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