Organization
LEWISTON APOTHECARY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAYSON B BULMAHN RPH (MANAGING MEMBER)
(716) 471-8067
Entity
Organization
Contact information
Practice address
400 PLAIN ST, LEWISTON, NY 14092-1627
(716) 754-4500
(716) 754-4521
Mailing address
400 PLAIN ST, LEWISTON, NY 14092-1627
(716) 754-4500
(716) 754-4521
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
027194
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02660644
—
NY
01
—
3343756
NCPDP
—
Enumeration date
07/29/2006
Last updated
03/07/2023
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