Organization
GGG61 CORP
Active
Other names
Concord Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY GIAMBRONE (PHARMACIST)
(716) 672-8400
Entity
Organization
Contact information
Practice address
10220 ROUTE 60, FREDONIA, NY 14063-1420
(716) 672-8400
(716) 672-8420
Mailing address
10220 ROUTE 60, FREDONIA, NY 14063-1420
(716) 672-8400
(716) 672-8420
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
031502
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03548038
—
NY
01
—
2138396
PK
—
Enumeration date
11/05/2012
Last updated
10/15/2019
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