Organization
PARKSIDE PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY JAMES JAY (PRESIDENT)
(716) 895-8811
Entity
Organization
Contact information
Practice address
975 BROADWAY ST, BUFFALO, NY 14212-1317
(716) 895-8811
(716) 895-1244
Mailing address
975 BROADWAY ST, BUFFALO, NY 14212-1317
(716) 895-8811
(716) 895-1244
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
017653
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00608604
—
NY
01
—
3314378
NCPDP
NY
Enumeration date
10/26/2006
Last updated
08/22/2020
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